0000895930-16-000111.txt : 20160202 0000895930-16-000111.hdr.sgml : 20160202 20160202170744 ACCESSION NUMBER: 0000895930-16-000111 CONFORMED SUBMISSION TYPE: 5 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20151231 FILED AS OF DATE: 20160202 DATE AS OF CHANGE: 20160202 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: AMSURG CORP CENTRAL INDEX KEY: 0000895930 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-OFFICES & CLINICS OF DOCTORS OF MEDICINE [8011] IRS NUMBER: 621493316 STATE OF INCORPORATION: TN FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 1A BURTON HILLS BLVD. CITY: NASHVILLE STATE: TN ZIP: 37215 BUSINESS PHONE: 615-665-1283 MAIL ADDRESS: STREET 1: 1A BURTON HILLS BLVD. CITY: NASHVILLE STATE: TN ZIP: 37215 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: JACOBS JOEY A CENTRAL INDEX KEY: 0001243878 FILING VALUES: FORM TYPE: 5 SEC ACT: 1934 Act SEC FILE NUMBER: 001-36531 FILM NUMBER: 161381781 MAIL ADDRESS: STREET 1: 830 CRESCENT CENTER DRIVE STREET 2: SUITE 610 CITY: FRANKLIN STATE: TN ZIP: 37067 5 1 wf-form5_145445085192283.xml FORM 5 X0306 5 2015-12-31 0 0 0 0000895930 AMSURG CORP AMSG 0001243878 JACOBS JOEY A C/O AMSURG 1A BURTON HILLS BLVD NASHVILLE TN 37215 1 0 0 0 Common stock 8375 D /s/ Joey A. Jacobs 2016-02-02