Is Center for Family Medicine active?

Yes — the South Dakota registry lists Center for Family Medicine as active, as of the 2026-06-17 source snapshot. The status is republished verbatim from the Secretary of State record.

Where is Center for Family Medicine registered?

Center for Family Medicine is registered in South Dakota under company number NS005124, first registered on June 23, 1972.

What type of company is Center for Family Medicine?

Center for Family Medicine is registered as a nonprofit corporation with the South Dakota Secretary of State.

How many employees does Center for Family Medicine have?

Center for Family Medicine has an estimated 19 employees as of plan year 2013 — a modeled figure derived from the retirement-plan participant counts in its DOL Form 5500 filings, not an official headcount.

Does Center for Family Medicine offer a 401(k) plan?

Yes — Form 5500 filings with the Department of Labor show Center for Family Medicine sponsors a 401(k) retirement plan, with reported plan assets of $433,221. Filings span 2009–2013. Details are in the Form 5500 section above.

Does Center for Family Medicine sponsor H-1B visas?

3 Labor Condition Applications (LCAs) filed by Center for Family Medicine appear in the DOL H-1B disclosure data, spanning FY 2011 to FY 2020. Each case, job title and offered wage is listed in the H-1B section above.

Does Center for Family Medicine have UCC liens?

No UCC financing statements name Center for Family Medicine as debtor in the indexed state registries.

Is Center for Family Medicine a federal contractor?

Center for Family Medicine appears in 1 federal recipient record (SAM.gov), indicating registration to receive federal awards. Obligation totals are not available for these records.

Does Center for Family Medicine hold any licenses?

19 license and credential records are matched to Center for Family Medicine. Each license, its type and issuing authority is listed in the Licenses section above.

What is the EIN of Center for Family Medicine?

The Employer Identification Number (EIN) on record for Center for Family Medicine is 582606157.

What public records are linked to Center for Family Medicine?

31 public records are linked to Center for Family Medicine: 1 in Filings, 19 in Licenses & authorities, 1 in Loans, 3 in H-1B, 7 in 401(k) — matched across federal, state and municipal registers by its registered legal names.

Where does this data come from?

Every fact on this profile is republished from official public registers — Secretary of State filings, UCC indexes and federal datasets. Each section names its issuing register and the snapshot Netstate last retrieved (latest: 2026-06-17).

Center for Family Medicine — South Dakota Nonprofit corporation No. NS005124: Active, 1 filing

Center for Family Medicine is a South Dakota nonprofit corporation, registered on June 23, 1972. It is based at 1115 EAST 20TH STREET, SIOUX FALLS, SD, 57105-1013. The company is currently listed as active on the South Dakota register, is registered under company number NS005124 and carries EIN 582606157. Public records for the company include 1 SoS registration, 1 federal contract, 1 loan record, 3 H-1B filings, 19 Medicare provider records, 2 non-profit filings and 7 Form 5500 filings. Every fact here is republished from an official public register and traces back to a primary source document.

Legal entity name	Center for Family Medicine
Principal address	1115 EAST 20TH STREETSIOUX FALLS57105-1013SDUnited States
Registration state	South Dakota
Status	Active
Registered	23 June 1972 (about 54 years ago)
Entity type	Nonprofit corporation
Standing	compliant
Company number	NS005124
EIN	582606157
Employees (modeled)	≈19 employees2013
H-1B filings	3 LCA filings, FY 2011–2020
Registered agent	Denisa Arapovic

Source registry	South Dakota Secretary of State · updated 15 June 2026

Public records	1 SoS registration

Est. revenue (modeled)	$2.4M2013
Nonprofit	Yes · 1 IRS filing
IRS exempt status	501(c)(3) · ruled January 1975 · contributions deductible
NTEE category	B54Z · Education
Revenue (IRS)	$5,138,994 · tax year 2025
Income (IRS)	$5,141,212 · tax year 2025
Assets (IRS)	$6,296,942 · tax year 2025
Form 990 filings	1 return · latest 990 (2020)
Federal contractor	Yes · 1 federal recipient record (SAM)
SBA loans	$1.3M · approved amounts

State	Business name	Filed	Registered agent	Officers	Status
South DakotaTHIS	Center for Family Medicine	1972-06-23	Denisa Arapovic	—	Active
Filing ID NS005124 Jurisdiction Domestic · Nonprofit corporation Principal address 1115 EAST 20TH STREET, SIOUX FALLS, SD, 57105-1013 Registered agent Denisa Arapovic1115 EAST 20TH STREET, SIOUX FALLS, SD, 57105 Officers Not reported

State	License / ID	Type	Issued	Status
—	1235898073	Medicare / NPI provider	12/09/2021	Unknown
credential — deactivation date — entity type code 2 enumeration date 12/09/2021 first name — last name — last update date 07/27/2023 mailing address 1 1115 E 20TH ST mailing address 2 — mailing city SIOUX FALLS mailing country US mailing postal code 571051013 mailing state SD middle name — npi 1235898073 organization name CENTER FOR FAMILY MEDICINE practice address 1 1115 E 20TH ST practice city SIOUX FALLS practice postal code 571051013 practice state SD reactivation date — taxonomy code 1 172V00000X Source: NPI registry · document npi/
—	1518924877	Medicare / NPI provider	04/28/2006	Unknown
credential — deactivation date — entity type code 2 enumeration date 04/28/2006 first name — last name — last update date 08/22/2020 mailing address 1 111 N PINE ST mailing address 2 — mailing city TRENTON mailing country US mailing postal code 307522503 mailing state GA middle name — npi 1518924877 organization name CENTER FOR FAMILY MEDICINE practice address 1 111 N PINE ST practice city TRENTON practice postal code 307522503 practice state GA reactivation date — taxonomy code 1 363AM0700X Source: NPI registry · document npi/
—	1093771032	Medicare / NPI provider	04/26/2006	Unknown
credential — deactivation date — entity type code 2 enumeration date 04/26/2006 first name — last name — last update date 06/10/2016 mailing address 1 PO BOX 1077 mailing address 2 — mailing city TRENTON mailing country US mailing postal code 307521077 mailing state GA middle name — npi 1093771032 organization name CENTER FOR FAMILY MEDICINE practice address 1 111 N PINE ST practice city TRENTON practice postal code 307522503 practice state GA reactivation date — taxonomy code 1 207R00000X Source: NPI registry · document npi/
—	1821058017	Medicare / NPI provider	03/23/2006	Unknown
credential — deactivation date — entity type code 2 enumeration date 03/23/2006 first name — last name — last update date 08/22/2020 mailing address 1 55 HOLLY SPRINGS PARK DR mailing address 2 — mailing city FRANKLIN mailing country US mailing postal code 287340719 mailing state NC middle name — npi 1821058017 organization name CENTER FOR FAMILY MEDICINE practice address 1 55 HOLLY SPRINGS PARK DR practice city FRANKLIN practice postal code 287340719 practice state NC reactivation date — taxonomy code 1 207Q00000X Source: NPI registry · document npi/
—	1164493672	Medicare / NPI provider	02/01/2006	Unknown
credential — deactivation date — entity type code 2 enumeration date 02/01/2006 first name — last name — last update date 05/23/2023 mailing address 1 1115 E 20TH ST mailing address 2 — mailing city SIOUX FALLS mailing country US mailing postal code 571051013 mailing state SD middle name — npi 1164493672 organization name CENTER FOR FAMILY MEDICINE practice address 1 1115 E 20TH ST practice city SIOUX FALLS practice postal code 571051013 practice state SD reactivation date — taxonomy code 1 207Q00000X Source: NPI registry · document npi/
South Dakota	1194465468	FAMILY PRACTICE	—	Unknown
address id SD571051013SI1115XSTXX400 address line 1 1115 E 20TH ST address line 2 — address line 2 suppressed — city SIOUX FALLS credential MD facility name CENTER FOR FAMILY MEDICINE first name LUCIA gender F graduation year 2021 group accepts assignment Y individual accepts assignment Y individual enrollment id I20251126004168 individual pac id 8921480450 last name GONZALEZ medical school OTHER middle name C npi 1194465468 num organization members 14 organization pac id 2769478429 primary specialty FAMILY PRACTICE secondary specialty 1 — secondary specialty 2 — secondary specialty 3 — secondary specialty 4 — secondary specialty all — state SD suffix — telehealth — telephone number 6053391783 zip code 571051013 Source: CMS medicare providers · document cms-medicare/
South Dakota	1326007469	FAMILY PRACTICE	—	Unknown
address id SD571051013SI1115XSTXX400 address line 1 1115 E 20TH ST address line 2 — address line 2 suppressed — city SIOUX FALLS credential MD facility name CENTER FOR FAMILY MEDICINE first name MARK gender M graduation year 1995 group accepts assignment Y individual accepts assignment Y individual enrollment id I20061228000420 individual pac id 4082515069 last name HUNTINGTON medical school MICHIGAN STATE UNIVERSITY COLLEGE OF HUMAN MEDICINE middle name K npi 1326007469 num organization members 14 organization pac id 2769478429 primary specialty FAMILY PRACTICE secondary specialty 1 — secondary specialty 2 — secondary specialty 3 — secondary specialty 4 — secondary specialty all — state SD suffix SR. telehealth — telephone number 6053391783 zip code 571051013 Source: CMS medicare providers · document cms-medicare/
South Dakota	1437507399	FAMILY PRACTICE	—	Unknown
address id SD571051013SI1115XSTXX400 address line 1 1115 E 20TH ST address line 2 — address line 2 suppressed — city SIOUX FALLS credential MD facility name CENTER FOR FAMILY MEDICINE first name SAMUEL gender M graduation year 2016 group accepts assignment Y individual accepts assignment Y individual enrollment id I20191210000672 individual pac id 3375887649 last name ZOLLICKER medical school KANSAS MEDICAL COLLEGE middle name M npi 1437507399 num organization members 14 organization pac id 2769478429 primary specialty FAMILY PRACTICE secondary specialty 1 — secondary specialty 2 — secondary specialty 3 — secondary specialty 4 — secondary specialty all — state SD suffix — telehealth — telephone number 6053391783 zip code 571051013 Source: CMS medicare providers · document cms-medicare/
South Dakota	1477780849	FAMILY PRACTICE	—	Unknown
address id SD571051013SI1115XSTXX400 address line 1 1115 E 20TH ST address line 2 — address line 2 suppressed — city SIOUX FALLS credential MD facility name CENTER FOR FAMILY MEDICINE first name GABRIEL gender M graduation year 2009 group accepts assignment Y individual accepts assignment Y individual enrollment id I20231006000981 individual pac id 1850685561 last name HARRIS medical school CREIGHTON UNIVERSITY SCHOOL OF MEDICINE middle name TAFF npi 1477780849 num organization members 14 organization pac id 2769478429 primary specialty FAMILY PRACTICE secondary specialty 1 — secondary specialty 2 — secondary specialty 3 — secondary specialty 4 — secondary specialty all — state SD suffix — telehealth — telephone number 6053391783 zip code 571051013 Source: CMS medicare providers · document cms-medicare/
South Dakota	1538151287	FAMILY PRACTICE	—	Unknown
address id SD571051013SI1115XSTXX400 address line 1 1115 E 20TH ST address line 2 — address line 2 suppressed — city SIOUX FALLS credential DO facility name CENTER FOR FAMILY MEDICINE first name BRADLEY gender M graduation year 1996 group accepts assignment Y individual accepts assignment Y individual enrollment id I20160719001392 individual pac id 3375612310 last name KAMSTRA medical school KANSAS CITY UNIVERSITY OF MED & BIOSCIENCES, COLLEGE OF OSTEO MED middle name D npi 1538151287 num organization members 14 organization pac id 2769478429 primary specialty FAMILY PRACTICE secondary specialty 1 — secondary specialty 2 — secondary specialty 3 — secondary specialty 4 — secondary specialty all — state SD suffix — telehealth — telephone number 6053391783 zip code 571051013 Source: CMS medicare providers · document cms-medicare/

State

License / ID

Type

Issued

Status

—

1235898073

Medicare / NPI provider

12/09/2021

Unknown

credential

—

deactivation date

—

entity type code

enumeration date

12/09/2021

first name

—

last name

—

last update date

07/27/2023

mailing address 1

1115 E 20TH ST

mailing address 2

—

mailing city

SIOUX FALLS

mailing country

mailing postal code

571051013

mailing state

middle name

—

npi

1235898073

organization name

CENTER FOR FAMILY MEDICINE

practice address 1

1115 E 20TH ST

practice city

SIOUX FALLS

practice postal code

571051013

practice state

reactivation date

—

taxonomy code 1

172V00000X

Source: NPI registry · document npi/

—

1518924877

Medicare / NPI provider

04/28/2006

Unknown

credential

—

deactivation date

—

entity type code

enumeration date

04/28/2006

first name

—

last name

—

last update date

08/22/2020

mailing address 1

111 N PINE ST

mailing address 2

—

mailing city

TRENTON

mailing country

mailing postal code

307522503

mailing state

middle name

—

npi

1518924877

organization name

CENTER FOR FAMILY MEDICINE

practice address 1

111 N PINE ST

practice city

TRENTON

practice postal code

307522503

practice state

reactivation date

—

taxonomy code 1

363AM0700X

Source: NPI registry · document npi/

—

1093771032

Medicare / NPI provider

04/26/2006

Unknown

credential

—

deactivation date

—

entity type code

enumeration date

04/26/2006

first name

—

last name

—

last update date

06/10/2016

mailing address 1

PO BOX 1077

mailing address 2

—

mailing city

TRENTON

mailing country

mailing postal code

307521077

mailing state

middle name

—

npi

1093771032

organization name

CENTER FOR FAMILY MEDICINE

practice address 1

111 N PINE ST

practice city

TRENTON

practice postal code

307522503

practice state

reactivation date

—

taxonomy code 1

207R00000X

Source: NPI registry · document npi/

—

1821058017

Medicare / NPI provider

03/23/2006

Unknown

credential

—

deactivation date

—

entity type code

enumeration date

03/23/2006

first name

—

last name

—

last update date

08/22/2020

mailing address 1

55 HOLLY SPRINGS PARK DR

mailing address 2

—

mailing city

FRANKLIN

mailing country

mailing postal code

287340719

mailing state

middle name

—

npi

1821058017

organization name

CENTER FOR FAMILY MEDICINE

practice address 1

55 HOLLY SPRINGS PARK DR

practice city

FRANKLIN

practice postal code

287340719

practice state

reactivation date

—

taxonomy code 1

207Q00000X

Source: NPI registry · document npi/

—

1164493672

Medicare / NPI provider

02/01/2006

Unknown

credential

—

deactivation date

—

entity type code

enumeration date

02/01/2006

first name

—

last name

—

last update date

05/23/2023

mailing address 1

1115 E 20TH ST

mailing address 2

—

mailing city

SIOUX FALLS

mailing country

mailing postal code

571051013

mailing state

middle name

—

npi

1164493672

organization name

CENTER FOR FAMILY MEDICINE

practice address 1

1115 E 20TH ST

practice city

SIOUX FALLS

practice postal code

571051013

practice state

reactivation date

—

taxonomy code 1

207Q00000X

Source: NPI registry · document npi/

South Dakota

1194465468

FAMILY PRACTICE

—

Unknown

address id

SD571051013SI1115XSTXX400

address line 1

1115 E 20TH ST

address line 2

—

address line 2 suppressed

—

city

SIOUX FALLS

credential

facility name

CENTER FOR FAMILY MEDICINE

first name

LUCIA

gender

graduation year

2021

group accepts assignment

individual accepts assignment

individual enrollment id

I20251126004168

individual pac id

8921480450

last name

GONZALEZ

medical school

OTHER

middle name

npi

1194465468

num organization members

organization pac id

2769478429

primary specialty

FAMILY PRACTICE

secondary specialty 1

—

secondary specialty 2

—

secondary specialty 3

—

secondary specialty 4

—

secondary specialty all

—

state

suffix

—

telehealth

—

telephone number

6053391783

zip code

571051013

Source: CMS medicare providers · document cms-medicare/

South Dakota

1326007469

FAMILY PRACTICE

—

Unknown

address id

SD571051013SI1115XSTXX400

address line 1

1115 E 20TH ST

address line 2

—

address line 2 suppressed

—

city

SIOUX FALLS

credential

facility name

CENTER FOR FAMILY MEDICINE

first name

MARK

gender

graduation year

1995

group accepts assignment

individual accepts assignment

individual enrollment id

I20061228000420

individual pac id

4082515069

last name

HUNTINGTON

medical school

MICHIGAN STATE UNIVERSITY COLLEGE OF HUMAN MEDICINE

middle name

npi

1326007469

num organization members

organization pac id

2769478429

primary specialty

FAMILY PRACTICE

secondary specialty 1

—

secondary specialty 2

—

secondary specialty 3

—

secondary specialty 4

—

secondary specialty all

—

state

suffix

SR.

telehealth

—

telephone number

6053391783

zip code

571051013

Source: CMS medicare providers · document cms-medicare/

South Dakota

1437507399

FAMILY PRACTICE

—

Unknown

address id

SD571051013SI1115XSTXX400

address line 1

1115 E 20TH ST

address line 2

—

address line 2 suppressed

—

city

SIOUX FALLS

credential

facility name

CENTER FOR FAMILY MEDICINE

first name

SAMUEL

gender

graduation year

2016

group accepts assignment

individual accepts assignment

individual enrollment id

I20191210000672

individual pac id

3375887649

last name

ZOLLICKER

medical school

KANSAS MEDICAL COLLEGE

middle name

npi

1437507399

num organization members

organization pac id

2769478429

primary specialty

FAMILY PRACTICE

secondary specialty 1

—

secondary specialty 2

—

secondary specialty 3

—

secondary specialty 4

—

secondary specialty all

—

state

suffix

—

telehealth

—

telephone number

6053391783

zip code

571051013

Source: CMS medicare providers · document cms-medicare/

South Dakota

1477780849

FAMILY PRACTICE

—

Unknown

address id

SD571051013SI1115XSTXX400

address line 1

1115 E 20TH ST

address line 2

—

address line 2 suppressed

—

city

SIOUX FALLS

credential

facility name

CENTER FOR FAMILY MEDICINE

first name

GABRIEL

gender

graduation year

2009

group accepts assignment

individual accepts assignment

individual enrollment id

I20231006000981

individual pac id

1850685561

last name

HARRIS

medical school

CREIGHTON UNIVERSITY SCHOOL OF MEDICINE

middle name

TAFF

npi

1477780849

num organization members

organization pac id

2769478429

primary specialty

FAMILY PRACTICE

secondary specialty 1

—

secondary specialty 2

—

secondary specialty 3

—

secondary specialty 4

—

secondary specialty all

—

state

suffix

—

telehealth

—

telephone number

6053391783

zip code

571051013

Source: CMS medicare providers · document cms-medicare/

South Dakota

1538151287

FAMILY PRACTICE

—

Unknown

address id

SD571051013SI1115XSTXX400

address line 1

1115 E 20TH ST

address line 2

—

address line 2 suppressed

—

city

SIOUX FALLS

credential

facility name

CENTER FOR FAMILY MEDICINE

first name

BRADLEY

gender

graduation year

1996

group accepts assignment

individual accepts assignment

individual enrollment id

I20160719001392

individual pac id

3375612310

last name

KAMSTRA

medical school

KANSAS CITY UNIVERSITY OF MED & BIOSCIENCES, COLLEGE OF OSTEO MED

middle name

npi

1538151287

num organization members

organization pac id

2769478429

primary specialty

FAMILY PRACTICE

secondary specialty 1

—

secondary specialty 2

—

secondary specialty 3

—

secondary specialty 4

—

secondary specialty all

—

state

suffix

—

telehealth

—

telephone number

6053391783

zip code

571051013

Source: CMS medicare providers · document cms-medicare/

Amount	Approved	Lender	Jobs	Status
$1,281,200	04/04/2020	American Bank and Trust	82	Paid in Full
borrower address 1115 E 20th St borrower city SIOUX FALLS borrower name CENTER FOR FAMILY MEDICINE borrower state SD borrower zip 57105-1013 business age description Existing or more than 2 years old business type Non-Profit Organization congressional district SD- current approval amount 1281200 date approved 04/04/2020 debt interest proceed — ethnicity Unknown/NotStated forgiveness amount 1288282.19 forgiveness date 11/03/2020 franchise name — gender Unanswered health care proceed — hubzone indicator Y initial approval amount 1281200 jobs reported 82 lmi indicator Y loan number 4681117006 loan status Paid in Full loan status date 12/16/2020 mortgage interest proceed — naics code 622110 non profit Y originating lender American Bank and Trust originating lender city Sioux Falls originating lender location id 66723 originating lender state SD payroll proceed 1281200 processing method PPP project city SIOUX FALLS project county name MINNEHAHA project state SD project zip 57105-1013 race Unanswered refinance eidl proceed — rent proceed — rural urban indicator U sba guaranty percentage 100 sba office code 0876 servicing lender address 6810 S Minnesota Ave servicing lender city Sioux Falls servicing lender location id 66723 servicing lender name American Bank and Trust servicing lender state SD servicing lender zip 57108 term 24 undisbursed amount 0 utilities proceed — veteran Unanswered Source: SBA PPP loans · document sba-ppp/4681117006

Case	Filed	Job title	Wage	Worksite	Status
I-200-20221-758618	2020-08-07	Resident Physician	$61,500/yr	Sioux Falls	Certified
amended petition 0 attorney agent city Gallatin attorney agent state TN attorney first name Samira attorney last name Nichols case number I-200-20221-758618 case status Certified change employer 0 continued employment 0 decision date 2020-08-14T00:00:00 employer address1 1115 East 20th Street employer address2 — employer city Sioux Falls employer country UNITED STATES OF AMERICA employer dba — employer name Center for Family Medicine employer phone +16053391783 employer postal code 57105 employer state SD employment begin date 2020-08-25T00:00:00 employment end date 2021-08-24T00:00:00 fiscal year 2020 full time position Y h1b dependent N job title Resident Physician lawfirm name Law Office of Samira Nichols naics code 622110 new employment 1 original cert date — prevailing wage 58261 pw unit of pay Year pw wage level I received date 2020-08-07T00:00:00 soc code 29-1063.00 soc title Internists, General source file LCA_Disclosure_Data_FY2020_Q4 total worker positions 1 visa class H-1B wage rate from 61500 wage rate to — wage unit of pay Year willful violator N worksite address1 1115 East 20th Street worksite city Sioux Falls worksite county MINNEHAHA worksite postal code 57105 worksite state SD Source: DOL h1b disclosure · document dol-h1b/I-200-20221-758618
I-200-11193-897287	2011-07-13	STAFF ACCOUNTANT	$36,400/yr	TRENTON	CERTIFIED
case number I-200-11193-897287 case status CERTIFIED decision date 2011-07-19T00:00:00 employer address1 111 N. PINE STREET employer city TRENTON employer name CENTER FOR FAMILY MEDICINE employer postal code 30752 employer state GA employment begin date 2011-08-22T00:00:00 employment end date 2014-08-21T00:00:00 fiscal year 2011 full time position Y job title STAFF ACCOUNTANT naics code 621111 prevailing wage 36400 pw unit of pay Year received date 2011-07-13T00:00:00 soc code 13-2011 soc title Accountants and Auditors source file H-1B_iCert_LCA_FY2011_Q4 total worker positions 1 visa class H-1B wage rate from 36400 wage rate to — wage unit of pay Year worksite city TRENTON worksite state GA Source: DOL h1b disclosure · document dol-h1b/I-200-11193-897287
I-200-10343-204494	2010-12-09	ACCOUNTANT	$19/hr	TRENTON	CERTIFIED
case number I-200-10343-204494 case status CERTIFIED decision date 2010-12-15T00:00:00 employer address1 111 NORTH PINE ST. employer city TRENTON employer name CENTER FOR FAMILY MEDICINE employer postal code 30752 employer state GA employment begin date 2011-01-01T00:00:00 employment end date 2013-01-01T00:00:00 fiscal year 2011 full time position N job title ACCOUNTANT naics code 62111 prevailing wage 16.93 pw unit of pay Hour received date 2010-12-09T00:00:00 soc code 13-2011.01 soc title Accountants source file H-1B_iCert_LCA_FY2011_Q4 total worker positions 1 visa class H-1B wage rate from 19.23 wage rate to — wage unit of pay Hour worksite city TRENTON worksite state GA Source: DOL h1b disclosure · document dol-h1b/I-200-10343-204494

Case

Filed

Job title

Wage

Worksite

Status

I-200-20221-758618

2020-08-07

Resident Physician

$61,500/yr

Sioux Falls

Certified

amended petition

attorney agent city

Gallatin

attorney agent state

attorney first name

Samira

attorney last name

Nichols

case number

I-200-20221-758618

case status

Certified

change employer

continued employment

decision date

2020-08-14T00:00:00

employer address1

1115 East 20th Street

employer address2

—

employer city

Sioux Falls

employer country

UNITED STATES OF AMERICA

employer dba

—

employer name

Center for Family Medicine

employer phone

+16053391783

employer postal code

57105

employer state

employment begin date

2020-08-25T00:00:00

employment end date

2021-08-24T00:00:00

fiscal year

2020

full time position

h1b dependent

job title

Resident Physician

lawfirm name

Law Office of Samira Nichols

naics code

622110

new employment

original cert date

—

prevailing wage

58261

pw unit of pay

Year

pw wage level

received date

2020-08-07T00:00:00

soc code

29-1063.00

soc title

Internists, General

source file

LCA_Disclosure_Data_FY2020_Q4

total worker positions

visa class

H-1B

wage rate from

61500

wage rate to

—

wage unit of pay

Year

willful violator

worksite address1

1115 East 20th Street

worksite city

Sioux Falls

worksite county

MINNEHAHA

worksite postal code

57105

worksite state

Source: DOL h1b disclosure · document dol-h1b/I-200-20221-758618

I-200-11193-897287

2011-07-13

STAFF ACCOUNTANT

$36,400/yr

TRENTON

CERTIFIED

case number

I-200-11193-897287

case status

CERTIFIED

decision date

2011-07-19T00:00:00

employer address1

111 N. PINE STREET

employer city

TRENTON

employer name

CENTER FOR FAMILY MEDICINE

employer postal code

30752

employer state

employment begin date

2011-08-22T00:00:00

employment end date

2014-08-21T00:00:00

fiscal year

2011

full time position

job title

STAFF ACCOUNTANT

naics code

621111

prevailing wage

36400

pw unit of pay

Year

received date

2011-07-13T00:00:00

soc code

13-2011

soc title

Accountants and Auditors

source file

H-1B_iCert_LCA_FY2011_Q4

total worker positions

visa class

H-1B

wage rate from

36400

wage rate to

—

wage unit of pay

Year

worksite city

TRENTON

worksite state

Source: DOL h1b disclosure · document dol-h1b/I-200-11193-897287

I-200-10343-204494

2010-12-09

ACCOUNTANT

$19/hr

TRENTON

CERTIFIED

case number

I-200-10343-204494

case status

CERTIFIED

decision date

2010-12-15T00:00:00

employer address1

111 NORTH PINE ST.

employer city

TRENTON

employer name

CENTER FOR FAMILY MEDICINE

employer postal code

30752

employer state

employment begin date

2011-01-01T00:00:00

employment end date

2013-01-01T00:00:00

fiscal year

2011

full time position

job title

ACCOUNTANT

naics code

62111

prevailing wage

16.93

pw unit of pay

Hour

received date

2010-12-09T00:00:00

soc code

13-2011.01

soc title

Accountants

source file

H-1B_iCert_LCA_FY2011_Q4

total worker positions

visa class

H-1B

wage rate from

19.23

wage rate to

—

wage unit of pay

Hour

worksite city

TRENTON

worksite state

Source: DOL h1b disclosure · document dol-h1b/I-200-10343-204494

Employees (modeled)	≈19 · plan year 2013
Est. annual revenue (modeled)	$2.4M
Retirement plan assets	$433,221
Benefit plans	401(k) plan on file
Filing history	5 plan years filed, 2009–2013
Sponsor EIN	58-2606157

Employees (modeled)

≈19 · plan year 2013

Est. annual revenue (modeled)

$2.4M

Retirement plan assets

$433,221

Benefit plans

401(k) plan on file

Filing history

5 plan years filed, 2009–2013

Sponsor EIN

58-2606157

Plan year	Employees (est.)	Participants	Plan assets	Revenue (est.)	401(k)
2013	≈19	17	$433,221	$2.4M	401(k)
ein 582606157 employees est 19 employer contrib usd 98423 estimate method v1-uncalibrated-2026-08-17 final filings 0 first filings 0 has 401k true has pension plan true has welfare plan false headcount basis total headcount suspect false is operating employer true last received 2014-06-11 naics 621111 naics rpe level 621111 naics rpe usd 244319 name CENTER FOR FAMILY MEDICINE participant contrib usd 35376 payroll est usd 505371 plan assets usd 433221 plan count 1 revenue est headcount usd 4642061 revenue est payroll usd 1207578 revenue est usd 2367626 signer name DR. ANUJ CHANDRA state GA total participants 17 year 2013 Source: DOL Form 5500 series (EBSA) · plan year 2013 · EIN 58-2606157
2012	≈19	17	$277,203	$2.4M	401(k)
ein 582606157 employees est 19 employer contrib usd 78002 estimate method v1-uncalibrated-2026-08-17 final filings 0 first filings 0 has 401k true has pension plan true has welfare plan false headcount basis total headcount suspect false is operating employer true last received 2013-04-16 naics 621111 naics rpe level 621111 naics rpe usd 244319 name CENTER FOR FAMILY MEDICINE participant contrib usd 35360 payroll est usd 505143 plan assets usd 277203 plan count 1 revenue est headcount usd 4642061 revenue est payroll usd 1207032 revenue est usd 2367090 signer name DR. ANUJ CHANDRA state GA total participants 17 year 2012 Source: DOL Form 5500 series (EBSA) · plan year 2012 · EIN 58-2606157
2011	≈17	15	$156,123	$1.5M	401(k)
admin name CENTER FOR FAMILY MEDICINE ein 582606157 employees est 17 employer contrib usd 5585 estimate method v1-uncalibrated-2026-08-17 final filings 0 first filings 0 has 401k true has pension plan true has welfare plan false headcount basis total headcount suspect false is operating employer true last received 2012-09-25 naics 621111 naics rpe level 621111 naics rpe usd 244319 name CENTER FOR FAMILY MEDICINE participant contrib usd 16653 payroll est usd 237900 plan assets usd 156123 plan count 1 revenue est headcount usd 4153423 revenue est payroll usd 568459 revenue est usd 1536571 signer name DR. ANUJ CHANDRA state GA total participants 15 year 2011 Source: DOL Form 5500 series (EBSA) · plan year 2011 · EIN 58-2606157
2010	≈14	13	$39,142	$2.3M	401(k)
admin name CENTER FOR FAMILY MEDICINE ein 582606157 employees est 14 employer contrib usd 4504 estimate method v1-uncalibrated-2026-08-17 final filings 0 first filings 0 has 401k true has pension plan true has welfare plan false headcount basis total headcount suspect false is operating employer true last received 2011-09-29 naics 621111 naics rpe level 621111 naics rpe usd 244319 name CENTER FOR FAMILY MEDICINE participant contrib usd 46324 payroll est usd 661771 plan assets usd 39142 plan count 1 revenue est headcount usd 3420466 revenue est payroll usd 1581294 revenue est usd 2325675 signer name ANUJ CHANDRA state GA total participants 13 year 2010 Source: DOL Form 5500 series (EBSA) · plan year 2010 · EIN 58-2606157
2009	≈16	14	$24,787	$1.8M	401(k)
admin name CENTER FOR FAMILY MEDICINE ein 582606157 employees est 16 employer contrib usd 358 estimate method v1-uncalibrated-2026-08-17 final filings 0 first filings 1 has 401k true has pension plan true has welfare plan false headcount basis total headcount suspect false is operating employer true last received 2010-09-21 naics 621111 naics rpe level 621111 naics rpe usd 244319 name CENTER FOR FAMILY MEDICINE participant contrib usd 24422 payroll est usd 348886 plan assets usd 24787 plan count 1 revenue est headcount usd 3909104 revenue est payroll usd 833658 revenue est usd 1805230 signer name ANUJ CHANDRA state GA total participants 14 year 2009 Source: DOL Form 5500 series (EBSA) · plan year 2009 · EIN 58-2606157

Plan year

Employees (est.)

Participants

Plan assets

Revenue (est.)

401(k)

2013

≈19

$433,221

$2.4M

401(k)

ein

582606157

employees est

employer contrib usd

98423

estimate method

v1-uncalibrated-2026-08-17

final filings

first filings

has 401k

true

has pension plan

true

has welfare plan

false

headcount basis

total

headcount suspect

false

is operating employer

true

last received

2014-06-11

naics

621111

naics rpe level

621111

naics rpe usd

244319

name

CENTER FOR FAMILY MEDICINE

participant contrib usd

35376

payroll est usd

505371

plan assets usd

433221

plan count

revenue est headcount usd

4642061

revenue est payroll usd

1207578

revenue est usd

2367626

signer name

DR. ANUJ CHANDRA

state

total participants

year

2013

Source: DOL Form 5500 series (EBSA) · plan year 2013 · EIN 58-2606157

2012

≈19

$277,203

$2.4M

401(k)

ein

582606157

employees est

employer contrib usd

78002

estimate method

v1-uncalibrated-2026-08-17

final filings

first filings

has 401k

true

has pension plan

true

has welfare plan

false

headcount basis

total

headcount suspect

false

is operating employer

true

last received

2013-04-16

naics

621111

naics rpe level

621111

naics rpe usd

244319

name

CENTER FOR FAMILY MEDICINE

participant contrib usd

35360

payroll est usd

505143

plan assets usd

277203

plan count

revenue est headcount usd

4642061

revenue est payroll usd

1207032

revenue est usd

2367090

signer name

DR. ANUJ CHANDRA

state

total participants

year

2012

Source: DOL Form 5500 series (EBSA) · plan year 2012 · EIN 58-2606157

2011

≈17

$156,123

$1.5M

401(k)

admin name

CENTER FOR FAMILY MEDICINE

ein

582606157

employees est

employer contrib usd

5585

estimate method

v1-uncalibrated-2026-08-17

final filings

first filings

has 401k

true

has pension plan

true

has welfare plan

false

headcount basis

total

headcount suspect

false

is operating employer

true

last received

2012-09-25

naics

621111

naics rpe level

621111

naics rpe usd

244319

name

CENTER FOR FAMILY MEDICINE

participant contrib usd

16653

payroll est usd

237900

plan assets usd

156123

plan count

revenue est headcount usd

4153423

revenue est payroll usd

568459

revenue est usd

1536571

signer name

DR. ANUJ CHANDRA

state

total participants

year

2011

Source: DOL Form 5500 series (EBSA) · plan year 2011 · EIN 58-2606157

2010

≈14

$39,142

$2.3M

401(k)

admin name

CENTER FOR FAMILY MEDICINE

ein

582606157

employees est

employer contrib usd

4504

estimate method

v1-uncalibrated-2026-08-17

final filings

first filings

has 401k

true

has pension plan

true

has welfare plan

false

headcount basis

total

headcount suspect

false

is operating employer

true

last received

2011-09-29

naics

621111

naics rpe level

621111

naics rpe usd

244319

name

CENTER FOR FAMILY MEDICINE

participant contrib usd

46324

payroll est usd

661771

plan assets usd

39142

plan count

revenue est headcount usd

3420466

revenue est payroll usd

1581294

revenue est usd

2325675

signer name

ANUJ CHANDRA

state

total participants

year

2010

Source: DOL Form 5500 series (EBSA) · plan year 2010 · EIN 58-2606157

2009

≈16

$24,787

$1.8M

401(k)

admin name

CENTER FOR FAMILY MEDICINE

ein

582606157

employees est

employer contrib usd

358

estimate method

v1-uncalibrated-2026-08-17

final filings

first filings

has 401k

true

has pension plan

true

has welfare plan

false

headcount basis

total

headcount suspect

false

is operating employer

true

last received

2010-09-21

naics

621111

naics rpe level

621111

naics rpe usd

244319

name

CENTER FOR FAMILY MEDICINE

participant contrib usd

24422

payroll est usd

348886

plan assets usd

24787

plan count

revenue est headcount usd

3909104

revenue est payroll usd

833658

revenue est usd

1805230

signer name

ANUJ CHANDRA

state

total participants

year

2009

Source: DOL Form 5500 series (EBSA) · plan year 2009 · EIN 58-2606157

Plan	Plan year	Participants	EIN
CENTER FOR FAMILY MEDICINE 401(K) PS	—	—	—
ack id 20110929205432P030045766375001 admin ein 582606157 admin name CENTER FOR FAMILY MEDICINE business code 621111 date received 2011-09-29 filing status FILING_RECEIVED filing year 2010 form type 5500_SF pension benefit code 2E2T3D2F2G2J2K2S2A plan effective date 2009-11-15 plan name CENTER FOR FAMILY MEDICINE 401(K) PS plan number 001 plan year begin date 2010-01-01 sponsor address1 111 NORTH PINE ST sponsor address2 — sponsor city TRENTON sponsor dba name — sponsor ein 582606157 sponsor name CENTER FOR FAMILY MEDICINE sponsor phone 4236488008 sponsor state GA sponsor zip 30752 tax period 2010-12-31 total assets boy 24787 total assets eoy 39142 total participants boy 13 welfare benefit code — Source: DOL form 5500 · document dol-5500/
CENTER FOR FAMILY MEDICINE 401(K) PS	—	—	—
ack id 20130416081119P040062896677001 admin ein — admin name — business code 621111 date received 2013-04-16 filing status FILING_RECEIVED filing year 2012 form type 5500_SF pension benefit code 2A2E2F2G2J2K2T2S3D plan effective date 2009-11-15 plan name CENTER FOR FAMILY MEDICINE 401(K) PS plan number 001 plan year begin date 2012-01-01 sponsor address1 111 NORTH PINE STREET sponsor address2 — sponsor city TRENTEN sponsor dba name — sponsor ein 582606157 sponsor name CENTER FOR FAMILY MEDICINE sponsor phone — sponsor state GA sponsor zip 30752 tax period 2012-12-31 total assets boy 156123 total assets eoy 277203 total participants boy 17 welfare benefit code — Source: DOL form 5500 · document dol-5500/
CENTER FOR FAMILY MEDICINE 401(K) PS	—	—	—
ack id 20100921130707P030004888961001 admin ein 582606157 admin name CENTER FOR FAMILY MEDICINE business code 621111 date received 2010-09-21 filing status FILING_RECEIVED filing year 2009 form type 5500_SF pension benefit code 2E2T3D2F2G2J2K2S2A plan effective date 2009-11-15 plan name CENTER FOR FAMILY MEDICINE 401(K) PS plan number 001 plan year begin date 2009-11-15 sponsor address1 111 NORTH PINE sponsor address2 — sponsor city TRENTON sponsor dba name — sponsor ein 582606157 sponsor name CENTER FOR FAMILY MEDICINE sponsor phone 7066573360 sponsor state GA sponsor zip 30752 tax period 2009-12-31 total assets boy 0 total assets eoy 24787 total participants boy 14 welfare benefit code — Source: DOL form 5500 · document dol-5500/
CENTER FOR FAMILY MEDICINE 401(K) PLAN	—	—	—
ack id 20100727071202P070024624082001 admin ein 710888055 admin name CENTER FOR FAMILY MEDICINE business code 621111 date received 2010-07-27 filing status FILING_RECEIVED filing year 2009 form type 5500_SF pension benefit code 2E2F2G2J2K3D plan effective date 2002-10-01 plan name CENTER FOR FAMILY MEDICINE 401(K) PLAN plan number 001 plan year begin date 2009-01-01 sponsor address1 333 CONOVER DRIVE sponsor address2 — sponsor city FRANKLIN sponsor dba name — sponsor ein 710888055 sponsor name CENTER FOR FAMILY MEDICINE sponsor phone 9377463088 sponsor state OH sponsor zip 45005 tax period 2009-12-31 total assets boy 705347 total assets eoy 1036770 total participants boy 16 welfare benefit code — Source: DOL form 5500 · document dol-5500/
CENTER FOR FAMILY MEDICINE 401(K) PS	—	—	—
ack id 20140611082529P040388793059001 admin ein — admin name — business code 621111 date received 2014-06-11 filing status FILING_RECEIVED filing year 2013 form type 5500_SF pension benefit code 2A2E2F2G2J2K2T2S3D plan effective date 2009-11-15 plan name CENTER FOR FAMILY MEDICINE 401(K) PS plan number 001 plan year begin date 2013-01-01 sponsor address1 111 NORTH PINE STREET sponsor address2 — sponsor city TRENTEN sponsor dba name — sponsor ein 582606157 sponsor name CENTER FOR FAMILY MEDICINE sponsor phone — sponsor state GA sponsor zip 30752 tax period 2013-12-31 total assets boy 277203 total assets eoy 433221 total participants boy 17 welfare benefit code — Source: DOL form 5500 · document dol-5500/
CENTER FOR FAMILY MEDICINE 401(K) PS	—	—	—
ack id 20120925134342P030007626788001 admin ein 582606157 admin name CENTER FOR FAMILY MEDICINE business code 621111 date received 2012-09-25 filing status FILING_RECEIVED filing year 2011 form type 5500_SF pension benefit code 2A2E2F2G2J2K2T2S3D plan effective date 2009-11-15 plan name CENTER FOR FAMILY MEDICINE 401(K) PS plan number 001 plan year begin date 2011-01-01 sponsor address1 111 NORTH PINE STREET sponsor address2 — sponsor city TRENTEN sponsor dba name — sponsor ein 582606157 sponsor name CENTER FOR FAMILY MEDICINE sponsor phone — sponsor state GA sponsor zip 30752 tax period 2011-12-31 total assets boy 39142 total assets eoy 156123 total participants boy 15 welfare benefit code — Source: DOL form 5500 · document dol-5500/
CENTER FOR FAMILY MEDICINE 401(K) PLAN	—	—	—
ack id 20110407071357P040012272551001 admin ein 710888055 admin name CENTER FOR FAMILY MEDICINE business code 621111 date received 2011-04-07 filing status FILING_RECEIVED filing year 2010 form type 5500_SF pension benefit code 2E2F2G2J2K3D plan effective date 2002-10-01 plan name CENTER FOR FAMILY MEDICINE 401(K) PLAN plan number 001 plan year begin date 2010-01-01 sponsor address1 333 CONOVER DRIVE sponsor address2 — sponsor city FRANKLIN sponsor dba name — sponsor ein 710888055 sponsor name CENTER FOR FAMILY MEDICINE sponsor phone 9377463088 sponsor state OH sponsor zip 45005 tax period 2010-12-31 total assets boy 1036770 total assets eoy 1252758 total participants boy 16 welfare benefit code — Source: DOL form 5500 · document dol-5500/

Plan

Plan year

Participants

EIN

CENTER FOR FAMILY MEDICINE 401(K) PS

—

ack id

20110929205432P030045766375001

admin ein

582606157

admin name

CENTER FOR FAMILY MEDICINE

business code

621111

date received

2011-09-29

filing status

FILING_RECEIVED

filing year

2010

form type

5500_SF

pension benefit code

2E2T3D2F2G2J2K2S2A

plan effective date

2009-11-15

plan name

CENTER FOR FAMILY MEDICINE 401(K) PS

plan number

001

plan year begin date

2010-01-01

sponsor address1

111 NORTH PINE ST

sponsor address2

—

sponsor city

TRENTON

sponsor dba name

—

sponsor ein

582606157

sponsor name

CENTER FOR FAMILY MEDICINE

sponsor phone

4236488008

sponsor state

sponsor zip

30752

tax period

2010-12-31

total assets boy

24787

total assets eoy

39142

total participants boy

welfare benefit code

—

Source: DOL form 5500 · document dol-5500/

CENTER FOR FAMILY MEDICINE 401(K) PS

—

ack id

20130416081119P040062896677001

admin ein

—

admin name

—

business code

621111

date received

2013-04-16

filing status

FILING_RECEIVED

filing year

2012

form type

5500_SF

pension benefit code

2A2E2F2G2J2K2T2S3D

plan effective date

2009-11-15

plan name

CENTER FOR FAMILY MEDICINE 401(K) PS

plan number

001

plan year begin date

2012-01-01

sponsor address1

111 NORTH PINE STREET

sponsor address2

—

sponsor city

TRENTEN

sponsor dba name

—

sponsor ein

582606157

sponsor name

CENTER FOR FAMILY MEDICINE

sponsor phone

—

sponsor state

sponsor zip

30752

tax period

2012-12-31

total assets boy

156123

total assets eoy

277203

total participants boy

welfare benefit code

—

Source: DOL form 5500 · document dol-5500/

CENTER FOR FAMILY MEDICINE 401(K) PS

—

ack id

20100921130707P030004888961001

admin ein

582606157

admin name

CENTER FOR FAMILY MEDICINE

business code

621111

date received

2010-09-21

filing status

FILING_RECEIVED

filing year

2009

form type

5500_SF

pension benefit code

2E2T3D2F2G2J2K2S2A

plan effective date

2009-11-15

plan name

CENTER FOR FAMILY MEDICINE 401(K) PS

plan number

001

plan year begin date

2009-11-15

sponsor address1

111 NORTH PINE

sponsor address2

—

sponsor city

TRENTON

sponsor dba name

—

sponsor ein

582606157

sponsor name

CENTER FOR FAMILY MEDICINE

sponsor phone

7066573360

sponsor state

sponsor zip

30752

tax period

2009-12-31

total assets boy

total assets eoy

24787

total participants boy

welfare benefit code

—

Source: DOL form 5500 · document dol-5500/

CENTER FOR FAMILY MEDICINE 401(K) PLAN

—

ack id

20100727071202P070024624082001

admin ein

710888055

admin name

CENTER FOR FAMILY MEDICINE

business code

621111

date received

2010-07-27

filing status

FILING_RECEIVED

filing year

2009

form type

5500_SF

pension benefit code

2E2F2G2J2K3D

plan effective date

2002-10-01

plan name

CENTER FOR FAMILY MEDICINE 401(K) PLAN

plan number

001

plan year begin date

2009-01-01

sponsor address1

333 CONOVER DRIVE

sponsor address2

—

sponsor city

FRANKLIN

sponsor dba name

—

sponsor ein

710888055

sponsor name

CENTER FOR FAMILY MEDICINE

sponsor phone

9377463088

sponsor state

sponsor zip

45005

tax period

2009-12-31

total assets boy

705347

total assets eoy

1036770

total participants boy

welfare benefit code

—

Source: DOL form 5500 · document dol-5500/

CENTER FOR FAMILY MEDICINE 401(K) PS

—

ack id

20140611082529P040388793059001

admin ein

—

admin name

—

business code

621111

date received

2014-06-11

filing status

FILING_RECEIVED

filing year

2013

form type

5500_SF

pension benefit code

2A2E2F2G2J2K2T2S3D

plan effective date

2009-11-15

plan name

CENTER FOR FAMILY MEDICINE 401(K) PS

plan number

001

plan year begin date

2013-01-01

sponsor address1

111 NORTH PINE STREET

sponsor address2

—

sponsor city

TRENTEN

sponsor dba name

—

sponsor ein

582606157

sponsor name

CENTER FOR FAMILY MEDICINE

sponsor phone

—

sponsor state

sponsor zip

30752

tax period

2013-12-31

total assets boy

277203

total assets eoy

433221

total participants boy

welfare benefit code

—

Source: DOL form 5500 · document dol-5500/

CENTER FOR FAMILY MEDICINE 401(K) PS

—

ack id

20120925134342P030007626788001

admin ein

582606157

admin name

CENTER FOR FAMILY MEDICINE

business code

621111

date received

2012-09-25

filing status

FILING_RECEIVED

filing year

2011

form type

5500_SF

pension benefit code

2A2E2F2G2J2K2T2S3D

plan effective date

2009-11-15

plan name

CENTER FOR FAMILY MEDICINE 401(K) PS

plan number

001

plan year begin date

2011-01-01

sponsor address1

111 NORTH PINE STREET

sponsor address2

—

sponsor city

TRENTEN

sponsor dba name

—

sponsor ein

582606157

sponsor name

CENTER FOR FAMILY MEDICINE

sponsor phone

—

sponsor state

sponsor zip

30752

tax period

2011-12-31

total assets boy

39142

total assets eoy

156123

total participants boy

welfare benefit code

—

Source: DOL form 5500 · document dol-5500/

CENTER FOR FAMILY MEDICINE 401(K) PLAN

—

ack id

20110407071357P040012272551001

admin ein

710888055

admin name

CENTER FOR FAMILY MEDICINE

business code

621111

date received

2011-04-07

filing status

FILING_RECEIVED

filing year

2010

form type

5500_SF

pension benefit code

2E2F2G2J2K3D

plan effective date

2002-10-01

plan name

CENTER FOR FAMILY MEDICINE 401(K) PLAN

plan number

001

plan year begin date

2010-01-01

sponsor address1

333 CONOVER DRIVE

sponsor address2

—

sponsor city

FRANKLIN

sponsor dba name

—

sponsor ein

710888055

sponsor name

CENTER FOR FAMILY MEDICINE

sponsor phone

9377463088

sponsor state

sponsor zip

45005

tax period

2010-12-31

total assets boy

1036770

total assets eoy

1252758

total participants boy

welfare benefit code

—

Source: DOL form 5500 · document dol-5500/

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