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  5. KATMAI ONCOLOGY GROUP, LLC

KATMAI ONCOLOGY GROUP, LLC

Contents

Company Details

Name: KATMAI ONCOLOGY GROUP, LLC
Jurisdiction: Alaska
Legal type: Limited Liability Company
Status: Good Standing
Date of registration: 19 Aug 2003 (21 years ago)
Entity Number: 81897D
ZIP code: 99508
County: Anchorage
Place of Formation: ALASKA
Address: 3851 PIPER ST, SUITE U340, ANCHORAGE, AK 99508
Mailing Address: 3851 PIPER ST STE U340, ANCHORAGE, AK 99508

Activity

Line of Business

62 Health Care and Social Assistance

NAICS

621111 OFFICES OF PHYSICIANS (EXCEPT MENTAL HEALTH SPECIALISTS)

Officers

Name Role
Theodore Kim Member
ELLEN CHIRICHELLA Member
SHANNON SMILEY Member
ELLEN CHIRICHELLA Registered Agent

Form 5500

Plan Name Plan Year EIN/PN Received Total number of participants
KATMAI ONCOLOGY GROUP LLC PROFIT SHARING PLAN 2020 920067999 2021-09-30 50
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1979-10-02
Sponsor KATMAI ONCOLOGY GROUP, LLC
Business code 621111
Sponsor’s telephone number 4802652794
Plan sponsor’s address 3851 PIPER STREET, SUITE U340, ANCHORAGE, AK, 99508

Signature of
Role Plan administrator
Date 2021-09-30
Name of individual signing JULIE NICKERSON
KATMAI ONCOLOGY GROUP LLC PROFIT SHARING PLAN 2020 920067999 2021-09-30 50
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1979-10-02
Sponsor KATMAI ONCOLOGY GROUP, LLC
Business code 621111
Sponsor’s telephone number 4802652794
Plan sponsor’s address 3851 PIPER STREET, SUITE U340, ANCHORAGE, AK, 99508

Signature of
Role Plan administrator
Date 2021-09-30
Name of individual signing JULIE NICKERSON
KATMAI ONCOLOGY GROUP LLC PROFIT SHARING PLAN 2019 920067999 2020-10-02 45
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1979-10-02
Sponsor KATMAI ONCOLOGY GROUP, LLC
Business code 621111
Sponsor’s telephone number 4802652794
Plan sponsor’s address 3851 PIPER STREET, SUITE U340, ANCHORAGE, AK, 99508

Signature of
Role Plan administrator
Date 2020-10-02
Name of individual signing JULIE NICKERSON
KATMAI ONCOLOGY GROUP LLC PROFIT SHARING PLAN 2018 920067999 2019-07-17 46
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1979-10-02
Sponsor KATMAI ONCOLOGY GROUP, LLC
Business code 621111
Sponsor’s telephone number 9076775807
Plan sponsor’s address 3851 PIPER STREET, SUITE U340, ANCHORAGE, AK, 99508

Signature of
Role Plan administrator
Date 2019-07-17
Name of individual signing TERRI TOPE
Role Employer/plan sponsor
Date 2019-07-17
Name of individual signing TERRI TOPE
KATMAI ONCOLOGY GROUP LLC PROFIT SHARING PLAN 2017 920067999 2018-06-22 47
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1979-10-02
Sponsor KATMAI ONCOLOGY GROUP, LLC
Business code 621111
Sponsor’s telephone number 9076775807
Plan sponsor’s address 3851 PIPER STREET, SUITE U340, ANCHORAGE, AK, 99508

Signature of
Role Plan administrator
Date 2018-06-22
Name of individual signing TERRI TOPE
Role Employer/plan sponsor
Date 2018-06-22
Name of individual signing TERRI TOPE
KATMAI ONCOLOGY GROUP LLC PROFIT SHARING PLAN 2016 920067999 2017-07-06 48
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1979-10-02
Sponsor KATMAI ONCOLOGY GROUP, LLC
Business code 621111
Sponsor’s telephone number 9076775807
Plan sponsor’s address 3851 PIPER STREET, SUITE U340, ANCHORAGE, AK, 99508

Signature of
Role Plan administrator
Date 2017-07-06
Name of individual signing TERRI TOPE
KATMAI ONCOLOGY GROUP, LLC PROFIT SHARING PLAN 2015 200326489 2016-02-06 43
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1979-10-02
Sponsor KATMAI ONCOLOGY GROUP, LLC
Business code 621111
Sponsor’s telephone number 9076775831
Plan sponsor’s address 3851 PIPER STREET, SUITE U340, ANCHORAGE, AK, 99508
KATMAI ONCOLOGY GROUP, LLC PROFIT SHARING PLAN 2014 200326489 2015-03-27 40
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1979-10-02
Sponsor KATMAI ONCOLOGY GROUP, LLC
Business code 621111
Sponsor’s telephone number 9076775831
Plan sponsor’s address 3851 PIPER STREET, SUITE U340, ANCHORAGE, AK, 99508

Signature of
Role Plan administrator
Date 2015-03-27
Name of individual signing JEANNE ANDERSON
KATMAI ONCOLOGY GROUP, LLC PROFIT SHARING PLAN 2013 200326489 2014-03-01 40
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1979-10-02
Sponsor KATMAI ONCOLOGY GROUP, LLC
Business code 621111
Sponsor’s telephone number 9076775831
Plan sponsor’s address 3851 PIPER STREET, SUITE U340, ANCHORAGE, AK, 99508

Signature of
Role Plan administrator
Date 2014-03-01
Name of individual signing JEANNE ANDERSON
KATMAI ONCOLOGY GROUP, LLC PROFIT SHARING PLAN 2012 200326489 2013-04-26 34
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1979-10-02
Sponsor KATMAI ONCOLOGY GROUP, LLC
Business code 621111
Sponsor’s telephone number 9076775831
Plan sponsor’s address 3851 PIPER STREET, SUITE U340, ANCHORAGE, AK, 99508

Signature of
Role Plan administrator
Date 2013-04-26
Name of individual signing DALE ISAAC WEBB

Licenses

Type License Number Status Date of issue Date of renewal Expiration date Description
Business License 430579 Active 2003-12-29 2024-02-19 2025-12-31 LOB: 62 - Health Care and Social Assistance, NAICS: 621111 - OFFICES OF PHYSICIANS (EXCEPT MENTAL HEALTH SPECIALISTS)
Telemedicine Business Registry 126253 Active 2017-09-05 - - -

Date of last update: 11 Jan 2025

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

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