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  5. INDEPENDENCE PARK MEDICAL SERVICES, INC.

INDEPENDENCE PARK MEDICAL SERVICES, INC.

Contents

Company Details

Name: INDEPENDENCE PARK MEDICAL SERVICES, INC.
Jurisdiction: Alaska
Legal type: Business Corporation
Status: Good Standing
Date of registration: 14 May 1984 (41 years ago)
Entity Number: 32858D
ZIP code: 99507
County: Anchorage
Place of Formation: ALASKA
Address: 9500 INDEPENDENCE PARK DRIVE, SUITE 900, ANCHORAGE, AK 99507
Mailing Address: 9500 INDEPENDENCE DR STE 900, ANCHORAGE, AK 99507

Activity

Line of Business

62 Health Care and Social Assistance

NAICS

621498 ALL OTHER OUTPATIENT CARE CENTERS

Officers

Name Role
Bradford W. Fenton Director
Pebbles Shanley Director
Pebbles Shanley Secretary
Pebbles Shanley Treasurer
Kathryn Ryan Director
Kathryn Ryan Shareholder
Kathryn Ryan President
Natasha Sherrill Shareholder
Charles D Kasmar Registered Agent
Bradford W. Fenton Shareholder

Form 5500

Plan Name Plan Year EIN/PN Received Total number of participants
INDEPENDENCE PARK MEDICAL SERVICES, INC. 401(K) PLAN 2023 920100075 2024-10-15 39
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1992-01-01
Sponsor INDEPENDENCE PARK MEDICAL SERVICES, INC.
Business code 621111
Sponsor’s telephone number 9075221341
Plan sponsor’s address 9500 INDEPENDENCE DR., SUITE 900, ANCHORAGE, AK, 99507

Signature of
Role Plan administrator
Date 2024-10-15
Name of individual signing YADIRA HALVERSON
Valid signature Filed with authorized/valid electronic signature
INDEPENDENCE PARK MEDICAL SERVICES, INC. 401(K) PLAN 2022 920100075 2023-10-05 43
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1992-01-01
Sponsor INDEPENDENCE PARK MEDICAL SERVICES, INC.
Business code 621111
Sponsor’s telephone number 9075221341
Plan sponsor’s address 9500 INDEPENDENCE DR., SUITE 900, ANCHORAGE, AK, 99507

Signature of
Role Plan administrator
Date 2023-10-05
Name of individual signing YADIRA HALVERSON
INDEPENDENCE PARK MEDICAL SERVICES, INC. 401(K) PLAN 2021 920100075 2022-10-06 42
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1992-01-01
Sponsor INDEPENDENCE PARK MEDICAL SERVICES, INC.
Business code 621111
Sponsor’s telephone number 9075221341
Plan sponsor’s address 9500 INDEPENDENCE DR., SUITE 900, ANCHORAGE, AK, 99507

Signature of
Role Plan administrator
Date 2022-10-06
Name of individual signing YADIRA HALVERSON
INDEPENDENCE PARK MEDICAL SERVICES, INC. 401(K) PLAN 2020 920100075 2021-10-05 42
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1992-01-01
Sponsor INDEPENDENCE PARK MEDICAL SERVICES, INC.
Business code 621111
Sponsor’s telephone number 9075221341
Plan sponsor’s address 9500 INDEPENDENCE DR., SUITE 900, ANCHORAGE, AK, 99507

Signature of
Role Plan administrator
Date 2021-10-05
Name of individual signing YADIRA HALVERSON
INDEPENDENCE PARK MEDICAL SERVICES, INC. 401(K) 2019 920100075 2020-10-15 40
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1992-01-01
Sponsor INDEPENDENCE PARK MEDICAL SERVICES, INC.
Business code 621111
Sponsor’s telephone number 9075221341
Plan sponsor’s address 9500 INDEPENDENCE DR., SUITE 900, ANCHORAGE, AK, 99507

Signature of
Role Plan administrator
Date 2020-10-15
Name of individual signing YADIRA HALVERSON
INDEPENDENCE PARK MEDICAL SERVICES, INC. 401(K) PLAN 2018 920100075 2019-07-11 31
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1992-01-01
Sponsor INDEPENDENCE PARK MEDICAL SERVICES, INC.
Business code 621111
Sponsor’s telephone number 9075221341
Plan sponsor’s address 9500 INDEPENDENCE DR., SUITE 900, ANCHORAGE, AK, 99507
INDEPENDENCE PARK MEDICAL SERVICES, INC. 401(K) PLAN 2017 920100075 2018-05-14 35
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1992-01-01
Sponsor INDEPENDENCE PARK MEDICAL SERVICES, INC.
Business code 621111
Sponsor’s telephone number 9075221341
Plan sponsor’s address 9500 INDEPENDENCE DR., SUITE 900, ANCHORAGE, AK, 99507

Signature of
Role Plan administrator
Date 2018-05-14
Name of individual signing RONALD E. CHRISTENSEN
INDEPENDENCE PARK MEDICAL SERVICES, INC. 401(K) PLAN 2016 920100075 2017-06-13 40
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1992-01-01
Sponsor INDEPENDENCE PARK MEDICAL SERVICES, INC.
Business code 621111
Sponsor’s telephone number 9075221341
Plan sponsor’s address 9500 INDEPENDENCE DR., SUITE 900, ANCHORAGE, AK, 99507

Signature of
Role Plan administrator
Date 2017-06-13
Name of individual signing HELEN SPENCER
INDEPENDENCE PARK MEDICAL SERVICES, INC. 401(K) PLAN 2015 920100075 2016-05-10 40
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1992-01-01
Sponsor INDEPENDENCE PARK MEDICAL SERVICES, INC.
Business code 621111
Sponsor’s telephone number 9075221341
Plan sponsor’s address 9500 INDEPENDENCE DR., SUITE 900, ANCHORAGE, AK, 99507

Signature of
Role Plan administrator
Date 2016-05-10
Name of individual signing HELEN SPENCER
INDEPENDENCE PARK MEDICAL SERVICES, INC. 401(K) PLAN 2014 920100075 2015-06-01 40
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1992-01-01
Sponsor INDEPENDENCE PARK MEDICAL SERVICES, INC.
Business code 621111
Sponsor’s telephone number 9075221341
Plan sponsor’s address 9500 INDEPENDENCE DR., SUITE 900, ANCHORAGE, AK, 99507

Signature of
Role Plan administrator
Date 2015-06-01
Name of individual signing HELEN SPENCER

Licenses

Type License Number Status Date of issue Date of renewal Expiration date Description
Business License 30664 Active - 2022-10-03 2024-12-31 LOB: 62 - Health Care and Social Assistance, NAICS: 621498 - ALL OTHER OUTPATIENT CARE CENTERS
Telemedicine Business Registry 167337 Active 2020-10-07 - - -

Date of last update: 11 Jan 2025

Sources: State of Alaska - Department of Commerce, Community, and Economic Development

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