UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
FORM 15
CERTIFICATION AND NOTICE OF TERMINATION OF REGISTRATION UNDER SECTION 12(g) OF THE SECURITIES EXCHANGE ACT OF 1934 OR SUSPENSION OF DUTY TO FILE REPORTS UNDER SECTIONS 13 AND 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934.
Commission File Numbers:001-36531, 333-201255 and 333-188062
AMSURG CORP.
and the subsidiary guarantors listed on Schedule A
(Exact name of registrant as specified in its charter)
1A Burton Hills Boulevard
Nashville, Tennessee 37215
(615) 665-1283
(Address, including zip code, and telephone number, including area code, of registrant’s principal executive offices)
Common Stock, no par value
5.250% Mandatory Convertible Preferred Stock, Series A-1, no par value
5.625% Senior Notes due 2022 (and Guarantees by Co-Registrants with respect thereto)
5.625% Senior Notes due 2020 (and Guarantees by Co-Registrants with respect thereto)
(Title of each class of securities covered by this Form)
None
(Titles of all other classes of securities for which a duty to file reports under section 13(a) or 15(d) remains)
Please place an X in the box(es) to designate the appropriate rule provision(s) relied upon to terminate or suspend the duty to file reports:
Rule 12g-4(a)(1) | ☒ | |
Rule 12g-4(a)(2) | ☐ | |
Rule 12h-3(b)(1)(i) | ☒ | |
Rule 12h-3(b)(1)(ii) | ☐ | |
Rule 15d-6 | ☐ |
Approximate number of holders of record as of the certification or notice date:
Common Stock, no par value — 0 holders
5.250% Mandatory Convertible Preferred Stock, Series A-1, no par value — 0 holders
5.625% Senior Notes due 2022 — 54 holders
5.625% Senior Notes due 2020 — 14 holders
SIGNATURES
Pursuant to the requirements of the Securities Exchange Act of 1934, Envision Healthcare Corporation, as successor by merger to AmSurg Corp., and each co-registrant listed on Schedule A hereto has duly caused this certification/notice to be signed on its behalf by the undersigned hereunto duly authorized.
ENVISION HEALTHCARE CORPORATION, as successor by merger to AmSurg Corp. Each Co-Registrant listed on Schedule A hereto | ||||||||||
| December 13, 2016 | By: | /s/ Claire M. Gulmi | ||||||||
| Name: | Claire M. Gulmi | |||||||||
| Title: | Executive Vice President and Chief Financial Officer of Envision Healthcare Corporation | |||||||||
Schedule A
Table of Co-Registrants
Exact Name of Registrant Guarantor as Specified in its Charter | State or Other Jurisdiction of Incorporation or Formation | I.R.S. Employer Identification Number | ||
AmSurg Holdings, Inc. (1) | Delaware | 62-1595888 | ||
AmSurg Anesthesia Management Services, LLC (1) | Tennessee | 27-1174941 | ||
AmSurg EC Topeka, Inc. (1) | Tennessee | 62-1512093 | ||
AmSurg EC St. Thomas, Inc. (1) | Tennessee | 62-1511996 | ||
AmSurg EC Beaumont, Inc. (1) | Tennessee | 62-1524208 | ||
AmSurg KEC, Inc. (1) | Tennessee | 62-1510489 | ||
AmSurg EC Santa Fe, Inc. (1) | Tennessee | 62-1523398 | ||
AmSurg EC Washington, Inc. (1) | Tennessee | 62-1506354 | ||
AmSurg Torrance, Inc. (1) | Tennessee | 62-1545685 | ||
AmSurg Abilene, Inc. (1) | Tennessee | 62-1555413 | ||
AmSurg Suncoast, Inc. (1) | Tennessee | 62-1555677 | ||
AmSurg Lorain, Inc. (1) | Tennessee | 62-1595307 | ||
AmSurg La Jolla, Inc. (1) | Tennessee | 62-1625304 | ||
AmSurg Hillmont, Inc. (1) | Tennessee | 62-1632685 | ||
AmSurg Palmetto, Inc. (1) | Tennessee | 62-1647404 | ||
AmSurg Northwest Florida, Inc. (1) | Tennessee | 62-1519549 | ||
AmSurg Ocala, Inc. (1) | Tennessee | 62-1650493 | ||
AmSurg Maryville, Inc. (1) | Tennessee | 62-1586143 | ||
AmSurg Miami, Inc. (1) | Tennessee | 62-1598504 | ||
AmSurg Burbank, Inc. (1) | Tennessee | 62-1619548 | ||
AmSurg Melbourne, Inc. (1) | Tennessee | 62-1625312 | ||
AmSurg El Paso, Inc. (1) | Tennessee | 62-1711537 | ||
AmSurg Crystal River, Inc. (1) | Tennessee | 62-1666189 | ||
AmSurg Abilene Eye, Inc. (1) | Tennessee | 62-1692556 | ||
AmSurg Inglewood, Inc. (1) | Tennessee | 62-1814134 | ||
AmSurg Glendale, Inc. (1) | Tennessee | 62-1807967 | ||
AmSurg San Antonio TX, Inc. (1) | Tennessee | 20-0075736 | ||
AmSurg San Luis Obispo CA, Inc. (1) | Tennessee | 20-1965555 | ||
AmSurg Temecula CA, Inc. (1) | Tennessee | 20-0095263 | ||
AmSurg Escondido CA, Inc. (1) | Tennessee | 20-1626979 | ||
AmSurg Scranton PA, Inc. (1) | Tennessee | 20-2853308 | ||
AmSurg Arcadia CA Inc. (1) | Tennessee | 20-4483684 | ||
AmSurg Main Line PA, Inc. (1) | Tennessee | 20-5408469 | ||
AmSurg Oakland CA, Inc. (1) | Tennessee | 20-5645841 | ||
AmSurg Lancaster PA, Inc. (1) | Tennessee | 20-5988960 | ||
AmSurg Pottsville PA, Inc. (1) | Tennessee | 26-0303835 | ||
AmSurg Glendora CA, Inc. (1) | Tennessee | 20-5732564 | ||
AmSurg Kissimmee FL, Inc. (1) | Tennessee | 62-1567628 | ||
AmSurg Altamonte Springs FL, Inc. (1) | Tennessee | 26-0289067 | ||
AmSurg New Port Richey FL, Inc. (1) | Tennessee | 62-1612176 | ||
AmSurg EC Centennial, Inc. (1) | Tennessee | 62-1511980 | ||
AmSurg Naples, Inc. (1) | Tennessee | 62-1659906 | ||
Illinois NSC, Inc. (1) | Tennessee | 20-2393903 | ||
NSC Healthcare, Inc. (1) | Tennessee | 84-1209756 | ||
NSC RBO West, LLC (1) | Tennessee | 26-3816052 | ||
NSC RBO East, LLC (1) | Tennessee | 27-3205481 | ||
Long Beach NSC, LLC (1) | Tennessee | 20-1048768 | ||
Torrance NSC, LLC (1) | Tennessee | 20-1048801 | ||
Davis NSC, LLC (1) | Tennessee | 20-5451784 |
Fullerton NSC, LLC (1) | Tennessee | 20-3435683 | ||
San Antonio NSC, LLC (1) | Tennessee | 20-0322582 | ||
Austin NSC, LLC (1) | Tennessee | 20-4942934 | ||
Twin Falls NSC, LLC (1) | Tennessee | 20-8086602 | ||
Ardmore NSC, LLC (1) | Tennessee | 26-1651465 | ||
Kenwood NSC, LLC (1) | Tennessee | 26-3055899 | ||
Towson NSC, LLC (1) | Tennessee | 20-0314129 | ||
Wilton NSC, LLC (1) | Connecticut | 26-1653853 | ||
NSC West Palm, LLC (1) | Tennessee | 76-0740666 | ||
Tampa Bay NSC, LLC (1) | Tennessee | 20-3447384 | ||
Coral Springs NSC, LLC (1) | Tennessee | 26-1649639 | ||
Weston NSC, LLC (1) | Tennessee | 26-3435641 | ||
AmSurg Fresno CA, Inc. (1) | Tennessee | 46-1290033 | ||
Austin NSC, L.P. (1) | Texas | 20-4943017 | ||
AmSurg Colton CA, Inc. (1) | Tennessee | 46-1462856 | ||
AmSurg Rockledge FL Anesthesia, LLC | Tennessee | 46-1848471 | ||
AmSurg Fresno Endoscopy, Inc. (1) | Tennessee | 46-4319557 | ||
AmSurg Temecula II, Inc. (1) | Tennessee | 46-4137624 | ||
AmSurg Finance, Inc. (1) | Tennessee | 47-2039667 | ||
SHI II, LLC (1) | Tennessee | 47-2039767 | ||
All Women’s Healthcare Holdings, Inc. (2) | Delaware | 13-4271816 | ||
All Women’s Healthcare, Inc. (2) | Florida | 42-1612456 | ||
All Women’s Healthcare of Dade, Inc. (2) | Florida | 45-0530994 | ||
All Women’s Healthcare of Sawgrass, Inc. (2) | Florida | 42-1612467 | ||
All Women’s Healthcare of West Broward, Inc. (2) | Florida | 42-1612462 | ||
All Women’s Healthcare Services, Inc. (2) | Florida | 45-0530996 | ||
Anesthesiologists of Greater Orlando, Inc. (2) | Florida | 59-3542796 | ||
Anesthesiology Associates of Tallahassee, Inc. (2) | Florida | 59-2970442 | ||
Bethesda Anesthesia Associates, Inc. (2) | Florida | 26-2588869 | ||
Boca Anesthesia Service, Inc. (2) | Florida | 65-0126861 | ||
Discovery Clinical Research, Inc. (2) | Florida | 20-1105922 | ||
Drs. Ellis, Rojas, Ross & Debs, Inc. (2) | Florida | 59-1205165 | ||
Flamingo Anesthesia Associates, Inc. (2) | Florida | 26-2804804 | ||
FM Healthcare Services, Inc. (2) | Florida | 27-3515257 | ||
FO Investments, Inc. (2) | Florida | 27-3515505 | ||
FO Investments II, Inc. (2) | Florida | 45-2641534 | ||
FO Investments III, Inc. (2) | Florida | 35-2438641 | ||
FMO Healthcare Holdings, Inc. (2) | Delaware | 27-3515065 | ||
Global Surgical Partners, Inc. (2) | Florida | 65-0903559 | ||
Greater Florida Anesthesiologists, LLC (2) | Florida | 27-0602251 | ||
Gynecologic Oncology Associates, Inc. (2) | Florida | 59-2026996 | ||
Jacksonville Beaches Anesthesia Associates, Inc. (2) | Florida | 26-2664313 | ||
Jupiter Anesthesia Associates, L.L.C. (2) | Florida | 26-1150385 | ||
Jupiter Healthcare, LLC (2) | Florida | 90-0997040 | ||
New Generations Babee Bag, Inc. (2) | Florida | 65-0878152 | ||
North Florida Perinatal Associates, Inc. (2) | Florida | 46-3234701 | ||
Parity Healthcare, Inc. (2) | Florida | 65-0360536 | ||
Partners in Medical Billing, Inc. (2) | Florida | 46-0638530 | ||
Physician Office Partners, Inc. (2) | Kansas | 74-3050016 | ||
Sheridan Anesthesia Services of Alabama, Inc. (2) | Florida | 46-1476545 | ||
Sheridan Anesthesia Services of Louisiana, Inc. (2) | Florida | 27-0983154 | ||
Sheridan Anesthesia Services of Oklahoma, Inc. (2) | Florida | 46-1722747 | ||
Sheridan Anesthesia Services of Virginia, Inc. (2) | Florida | 27-1895603 | ||
Sheridan Children’s Healthcare Services, Inc. (2) | Florida | 59-2347217 | ||
Sheridan Children’s Healthcare Services of Arizona, Inc. (2) | Florida | 47-1934541 | ||
Sheridan Children’s Healthcare Services of Louisiana, Inc. (2) | Florida | 46-2773044 |
Sheridan Children’s Healthcare Services of New Mexico, Inc. (2) | Florida | 83-0401457 | ||
Sheridan Children’s Healthcare Services of Virginia, Inc. (2) | Florida | 01-0622481 | ||
Sheridan Clinical Research, Inc. (2) | Florida | 65-1096710 | ||
Sheridan Emergency Physician Services, Inc. (2) | Florida | 65-1057394 | ||
Sheridan Emergency Physician Services of North Missouri, Inc. (2) | Florida | 46-5538742 | ||
Sheridan Emergency Physician Services of Missouri, Inc. (2) | Florida | 46-0617801 | ||
Sheridan Emergency Physician Services of South Florida, Inc. (2) | Florida | 46-2743595 | ||
Sheridan Healthcare, Inc. (2) | Delaware | 04-3252967 | ||
Sheridan Healthcare of Louisiana, Inc. (2) | Florida | 90-0196583 | ||
Sheridan Healthcare of Missouri, Inc. (2) | Florida | 20-3109582 | ||
Sheridan Healthcare of Vermont, Inc. (2) | Florida | 20-4063600 | ||
Sheridan Healthcare of Virginia, Inc. (2) | Florida | 27-1931953 | ||
Sheridan Healthcare of West Virginia, Inc. (2) | West Virginia | 65-1028803 | ||
Sheridan Healthcorp, Inc. (2) | Florida | 59-0971075 | ||
Sheridan Healthcorp of California, Inc. (2) | California | 46-4126626 | ||
Sheridan Healthy Hearing Services, Inc. (2) | Florida | 27-0417898 | ||
Sheridan Holdings, Inc. (2) | Delaware | 13-4056438 | ||
Sheridan InvestCo, LLC (2) | Delaware | 46-3274828 | ||
Sheridan Radiology Services, Inc. (2) | Delaware | 20-8211626 | ||
Southeast Perinatal Associates, Inc. (2) | Florida | 65-0363303 | ||
Sunbeam Asset LLC (2) | Delaware | 26-0312608 | ||
Tennessee Valley Neonatology, Inc. (2) | Florida | 27-5404223 | ||
Tiva Healthcare, Inc. (2) | Florida | 04-3721686 | ||
Sunbeam Intermediate Holdings, Inc. (2) | Delaware | 26-0206257 | ||
Sunbeam Primary Holdings, Inc. (2) | Delaware | 26-1126836 | ||
Anesthesia and Pain Management Services of California, Inc. (2) | California | 46-3806338 | ||
Anesthesiology of Jupiter, P.A. (2) | Florida | 65-0163043 | ||
Comprehensive Pain Medicine, Inc. (2) | Florida | 59-3129628 | ||
Comprehensive Teleradiology Solutions, Inc. (2) | Florida | 80-0953054 | ||
Coral Anesthesia Associates, Inc. (2) | Florida | 45-4660785 | ||
Florida United Radiology, L.C. (2) | Florida | 65-0887466 | ||
New Jersey Healthcare Specialists, P.C. (2) | New Jersey | 22-1948732 | ||
ICS Radiology, Inc. (2) | Florida | 45-3356647 | ||
Interventional Rehabilitation of South Florida, Inc. (2) | Florida | 65-0867955 | ||
Jupiter Imaging Associates, Inc. (2) | Florida | 65-0164050 | ||
Medical Anesthesia Consultants Medical Group, Inc. (2) | California | 68-0117704 | ||
North Texas Perinatal Associates, P.A. (2) | Texas | 75-2382044 | ||
Pain Physicians of Central Florida, P.A. (2) | Florida | 45-3912103 | ||
Sheridan Acquisition Associates, P.A. (2) | Florida | 20-5641357 | ||
Sheridan Acquisition Associates II, P.A. (2) | Florida | 26-1219178 | ||
Sheridan Anesthesia Services of Maryland, P.C. (2) | Maryland | 36-4551536 | ||
Sheridan Anesthesia Services of Minnesota, P.C. (2) | Minnesota | 46-1877451 | ||
Sheridan Children’s Healthcare Services of Colorado, P.C. (2) | Colorado | 20-8050077 | ||
Sheridan Children’s Healthcare Services of New Jersey, P.C. (2) | New Jersey | 27-2500879 | ||
Sheridan Children’s Healthcare Services of North Carolina, P.A. (2) | North Carolina | 57-1195202 | ||
Sheridan Children’s Healthcare Services of South Carolina, P.A. (2) | South Carolina | 46-0667408 | ||
Sheridan Children’s Healthcare Services of Tennessee, P.C. (2) | Tennessee | 45-4252387 | ||
Sheridan Critical Care Services, P.A. (2) | Florida | 46-3895683 | ||
Sheridan Emergency Physician Services of Georgia, LLC (2) | Georgia | 26-4498219 | ||
Sheridan Emergency Physician Services of South Carolina, P. A. (2) | South Carolina | 46-1302162 | ||
Sheridan Emergency Physician Services of South Dade, Inc. (2) | Florida | 20-4859734 | ||
Sheridan Healthcare of Arkansas, P.A. (2) | Arkansas | 86-1112056 | ||
Sheridan Healthcare of Connecticut, P.C. (2) | Connecticut | 61-1441438 | ||
Sheridan Healthcare of Massachusetts, P.C. (2) | Massachusetts | 26-1602923 | ||
Sheridan Healthcare of North Texas, P.A. (2) | Texas | 03-0509857 | ||
Sheridan Healthcare of Texas, P.A. (2) | Texas | 65-0603121 |
Sheridan Radiology Services of Central Florida, Inc. (2) | Florida | 20-8251783 | ||
Sheridan Radiology Services of Kentucky, Inc. (2) | Florida | 27-2107170 | ||
Sheridan Radiology Services of Pinellas, Inc. (2) | Florida | 38-3883031 | ||
Sheridan Radiology Services of South Florida, Inc. (2) | Florida | 20-5890948 | ||
Tri-County Pain Management, P.A. (2) | New Jersey | 83-0375709 |
| (1) | The address, including zip code, and telephone number, including area code, of this additional registrant’s principal executive offices is: c/o Envision Healthcare Corporation, 1A Burton Hills Boulevard, Nashville, Tennessee 37215, (615) 665-1283. |
The name, address, including zip code, and telephone number, including area code, of agent for service of this additional registrant is:
Claire M. Gulmi
Executive Vice President and Chief Financial Officer
1A Burton Hills Boulevard
Nashville, Tennessee 37215
(615) 665-1283
With copies to:
J. James Jenkins, Jr., Esq.
Bass, Berry & Sims PLC
150 Third Avenue South Suite 2800
Nashville, Tennessee 37201
(615) 742-6200
| (2) | The address, including zip code, and telephone number, including area code, of this additional registrant’s principal executive offices is: c/o Sheridan Healthcare, 7700 West Sunrise Boulevard, Plantation, Florida 33322, (800) 437-2672. |
The name, address, including zip code, and telephone number, including area code, of agent for service of this additional registrant is:
Jillian E. Marcus, Esq.
General Counsel, Physician Services
7700 West Sunrise Boulevard
Plantation, Florida 33322
(800) 437-2672
With copies to:
J. James Jenkins, Jr., Esq.
Bass, Berry & Sims PLC
150 Third Avenue South Suite 2800
Nashville, Tennessee 37201
(615) 742-6200