0001718392-19-000004.txt : 20191209 0001718392-19-000004.hdr.sgml : 20191209 20191209150244 ACCESSION NUMBER: 0001718392-19-000004 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b ITEM INFORMATION: 4a5 FILED AS OF DATE: 20191209 DATE AS OF CHANGE: 20191209 EFFECTIVENESS DATE: 20191209 FILER: COMPANY DATA: COMPANY CONFORMED NAME: Natural State Medical Group, LLC CENTRAL INDEX KEY: 0001718392 IRS NUMBER: 822172664 STATE OF INCORPORATION: AR FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-355087 FILM NUMBER: 191275076 BUSINESS ADDRESS: STREET 1: 5201 NORTHSHORE DRIVE CITY: NORTH LITTLE ROCK STATE: AR ZIP: 72118 BUSINESS PHONE: 501-690-2855 MAIL ADDRESS: STREET 1: 5201 NORTHSHORE DRIVE CITY: NORTH LITTLE ROCK STATE: AR ZIP: 72118 FORMER COMPANY: FORMER CONFORMED NAME: Natural State Medical Group, Inc. DATE OF NAME CHANGE: 20171002 D 1 primary_doc.xml X0708 D LIVE 0001718392 Natural State Medical Group, LLC 5201 NORTHSHORE DRIVE NORTH LITTLE ROCK AR ARKANSAS 72118 501-690-2855 ARKANSAS Natural State Medical Group, Inc. Limited Liability Company true 2019 James Adametz 17 Paradise Lane Little Rock AR ARKANSAS 72223 Executive Officer Director Promoter Zada Adametz 17 Paradise Lane Little Rock AR ARKANSAS 72223 Executive Officer Director Julia Hart 64 Chenal Circle Little Rock AR ARKANSAS 72223 Director Tommy Ives 1678 South Moore Road Hot Speings AR ARKANSAS 71913 Executive Officer Director Mel Collazo 14015 Belle Point Drive Little Rock AR ARKANSAS 72212 Director Charles Hart 64 Chenal Circle Little Rock AR ARKANSAS 72223 Director Sheri Collazo 14015 Belle Pointe Drive Little Rock AR ARKANSAS 72212 Director Donna Mooney 4109 Longview Little Rock AR ARKANSAS 72212 Director Lisa Shahim 36 Chenal Circle Little Rock AR ARKANSAS 72223 Director Agriculture No Revenues 06b 4a5 false 2019-12-04 false true false The Company was originally a corporation and has been converted into a limited liability company. This offering was made only to then existing members of the LLC. 0 None None None None 5201 Northshore Drive North Little Rock AR ARKANSAS 72118 AR ARKANSAS false 450000 450000 0 Membership Interests were offered only to existing Members and the Members all subscribed in their then existing percentage Membership Interests. false 9 0 0 0 false Natural State Medical Group, LLC S. Graham Catlett S. Graham Catlett Attorney under Power of Attorney 2019-12-09