0001567619-22-012381.txt : 20220606 0001567619-22-012381.hdr.sgml : 20220606 20220606161956 ACCESSION NUMBER: 0001567619-22-012381 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b FILED AS OF DATE: 20220606 DATE AS OF CHANGE: 20220606 EFFECTIVENESS DATE: 20220606 FILER: COMPANY DATA: COMPANY CONFORMED NAME: Evergreen Nephrology LLC CENTRAL INDEX KEY: 0001930772 IRS NUMBER: 000000000 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-448224 FILM NUMBER: 22998356 BUSINESS ADDRESS: STREET 1: 210 ATHENS WAY STREET 2: SUITE 200 CITY: NASHVILLE STATE: TN ZIP: 37208 BUSINESS PHONE: (833) 633-1290 MAIL ADDRESS: STREET 1: 210 ATHENS WAY STREET 2: SUITE 200 CITY: NASHVILLE STATE: TN ZIP: 37208 D 1 primary_doc.xml X0708 D LIVE 0001930772 Evergreen Nephrology LLC 210 Athens Way, Suite 200 Nashville TN TENNESSEE 37208 (833) 633-1290 DELAWARE None None Limited Liability Company true 2021 Adam Boehler 210 Athens Way, Suite 200 Nashville TN TENNESSEE 37208 Director Annie Lamont 210 Athens Way, Suite 200 Nashville TN TENNESSEE 37208 Director Matt Kim 210 Athens Way, Suite 200 Nashville TN TENNESSEE 37208 Director Abe Sutton 210 Athens Way, Suite 200 Nashville TN TENNESSEE 37208 Director Arjun Aggarwal 210 Athens Way, Suite 200 Nashville TN TENNESSEE 37208 Director Eric Jenkins 210 Athens Way, Suite 200 Nashville TN TENNESSEE 37208 Executive Officer Scott Lloyd 210 Athens Way, Suite 200 Nashville TN TENNESSEE 37208 Executive Officer Other Health Care Decline to Disclose 06b false 2022-05-22 false true false 1000 10000000 4335000 5665000 false 335 0 0 0 false Evergreen Nephrology LLC /s/ David M. Glaccum David M. Glaccum Authorized Signatory 2022-06-06