0001878843-24-000002.txt : 20240306 0001878843-24-000002.hdr.sgml : 20240306 20240306164713 ACCESSION NUMBER: 0001878843-24-000002 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b FILED AS OF DATE: 20240306 DATE AS OF CHANGE: 20240306 EFFECTIVENESS DATE: 20240306 FILER: COMPANY DATA: COMPANY CONFORMED NAME: One Nineteen GI ASC, LLC CENTRAL INDEX KEY: 0001878843 ORGANIZATION NAME: IRS NUMBER: 862162590 STATE OF INCORPORATION: AL FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-506870 FILM NUMBER: 24726620 BUSINESS ADDRESS: STREET 1: 7191 CAHABA VALLEY ROAD, STREET 2: SUITE 202 CITY: BIRMINGHAM STATE: AL ZIP: 35242 BUSINESS PHONE: 708-492-0531 MAIL ADDRESS: STREET 1: 7191 CAHABA VALLEY ROAD, STREET 2: SUITE 202 CITY: BIRMINGHAM STATE: AL ZIP: 35242 D 1 primary_doc.xml X0708 D LIVE 0001878843 One Nineteen GI ASC, LLC 7191 CAHABA VALLEY ROAD SUITE 202 BIRMINGHAM AL ALABAMA 35242 708-492-0531 ALABAMA None None Limited Liability Company true 2021 Charles A. Dasher, Jr. c/o One Nineteen GI ASC, LLC 7191 Cahaba Valley Road, Suite 202 Birmingham AL ALABAMA 35242 Executive Officer Director Riley Orr c/o One Nineteen GI ASC, LLC 7191 Cahaba Valley Road, Suite 202 Birmingham AL ALABAMA 35242 Executive Officer Director Scott Hughes c/o One Nineteen GI ASC, LLC 7191 Cahaba Valley Road, Suite 202 Birmingham AL ALABAMA 35242 Executive Officer Director Tim Puthoff c/o One Nineteen GI ASC, LLC 7191 Cahaba Valley Road, Suite 202 Birmingham AL ALABAMA 35242 Director Donny Kakati c/o One Nineteen GI ASC, LLC 7191 Cahaba Valley Road, Suite 202 Birmingham AL ALABAMA 35242 Director Owen McLean c/o One Nineteen GI ASC, LLC 7191 Cahaba Valley Road, Suite 202 Birmingham AL ALABAMA 35242 Director Michael Phillips c/o One Nineteen GI ASC, LLC 7191 Cahaba Valley Road, Suite 202 Birmingham AL ALABAMA 35242 Director Hospitals and Physicians Decline to Disclose 06b false 2024-03-01 false true false 175000 175000 175000 0 false 1 0 0 0 false One Nineteen GI ASC, LLC /s/ Riley Orr Riley Orr Manager 2024-03-06