0001889209-21-000001.txt : 20211027 0001889209-21-000001.hdr.sgml : 20211027 20211027100609 ACCESSION NUMBER: 0001889209-21-000001 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b FILED AS OF DATE: 20211027 DATE AS OF CHANGE: 20211027 EFFECTIVENESS DATE: 20211027 FILER: COMPANY DATA: COMPANY CONFORMED NAME: USA Baldwin County ASC, LLC CENTRAL INDEX KEY: 0001889209 IRS NUMBER: 844335937 STATE OF INCORPORATION: AL FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-418689 FILM NUMBER: 211351064 BUSINESS ADDRESS: STREET 1: 310 SEVEN SPRINGS WAY, SUITE 500 CITY: BRENTWOOD STATE: TN ZIP: 37027 BUSINESS PHONE: (615) 234-5900 MAIL ADDRESS: STREET 1: 310 SEVEN SPRINGS WAY, SUITE 500 CITY: BRENTWOOD STATE: TN ZIP: 37027 D 1 primary_doc.xml X0708 D LIVE 0001889209 USA Baldwin County ASC, LLC 310 SEVEN SPRINGS WAY, SUITE 500 BRENTWOOD TN TENNESSEE 37027 (615) 234-5900 ALABAMA None None Limited Liability Company true 2019 . USA BC ASC Holdco, LLC 310 Seven Springs Way, Suite 500 Brentwood TN TENNESSEE 37027 Promoter Administrative Member and Class B Member of the Company . South Alabama Health Care Authority 2451 University Hospital Drive Mobile AL ALABAMA 36617 Promoter 51% owner of the Administrative Member . Surgery Center Holdings, Inc. 310 Seven Springs Way, Suite 500 Brentwood TN TENNESSEE 37027 Promoter 49% owner of the Administrative Member . Surgery Partners, Inc. 310 Seven Springs Way, Suite 500 Brentwood TN TENNESSEE 37027 Promoter Jennifer Baldock 310 Seven Springs Way, Suite 500 Brentwood TN TENNESSEE 37027 Executive Officer Secretary and Treasurer of the Company Owen Bailey 2451 University Hospital Drive Mobile AL ALABAMA 36617 Executive Officer President of the Company and Manager of the Administrative Member Alan Whaley 2451 University Hospital Drive Mobile AL ALABAMA 36617 Promoter Manager of the Administrative Member John Marymont 2451 University Hospital Drive Mobile AL ALABAMA 36617 Promoter Manager of the Administrative Member George Goodwin 310 Seven Springs Way, Suite 500 Brentwood TN TENNESSEE 37027 Promoter Manager of the Administrative Member Steven Marshall 310 Seven Springs Way, Suite 500 Brentwood TN TENNESSEE 37027 Promoter Manager of the Administrative Member Other Health Care Decline to Disclose 06b false true false true false 25000 The Securities Group, LLC 118148 Betty Gearhart 735679 6465 North Quail Hollow Road Suite 400 Memphis TN TENNESSEE 38120 AL ALABAMA false 5000000 0 5000000 false 0 15000 0 75000 Development Fee made payable to SP Management Services, Inc., a subsidiary of Surgery Partners, Inc. false USA Baldwin County ASC, LLC /s/ Jennifer Baldock Jennifer Baldock Secretary and Treasurer 2021-10-27