0001209191-13-006190.txt : 20130204 0001209191-13-006190.hdr.sgml : 20130204 20130204184425 ACCESSION NUMBER: 0001209191-13-006190 CONFORMED SUBMISSION TYPE: 5 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20121231 FILED AS OF DATE: 20130204 DATE AS OF CHANGE: 20130204 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: HERR HENRY D CENTRAL INDEX KEY: 0000903096 FILING VALUES: FORM TYPE: 5 SEC ACT: 1934 Act SEC FILE NUMBER: 000-22217 FILM NUMBER: 13571530 MAIL ADDRESS: STREET 1: ONE BURTON HILLS BLVD CITY: NASHVILLE STATE: TN ZIP: 37215 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: 0512 BUSINESS ADDRESS: STREET 1: 20 BURTON HILLS BLVD. STREET 2: SUITE 500 CITY: NASHVILLE STATE: TN ZIP: 37215 BUSINESS PHONE: 615-665-1283 MAIL ADDRESS: STREET 1: 20 BURTON HILLS BLVD. STREET 2: SUITE 500 CITY: NASHVILLE STATE: TN ZIP: 37215 5 1 doc5.xml FORM 5 SUBMISSION X0306 5 2012-12-31 0 0 0 0000895930 AMSURG CORP AMSG 0000903096 HERR HENRY D 2490 CLIFFTOPS AVENUE MONTEAGLE TN 37356 1 0 0 0 Common stock 107335 D /s/ Henry D. Herr 2013-02-04