2023-07-28T13:34:28-05:00 2022-12-31 390859910 BAKER TILLY US LLP PO BOX 908 BRIDGEPORT WV 26330 990 2022-01-01 743226821 WEST VIRGINIA MEDICAL PROFESSIONALS HEALTH PROGRAM INC WEST 3049331030 4013 BUCKHANNON PIKE MOUNT CLARE WV 26408 P BRADLEY HALL MD MEDICAL DIRECTOR 3046779283 2023-05-31 1 P BRADLEY HALL MD 999009999 0 THEODORE A LOPEZ P00247850 3046245471 2023-05-31 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z P BRADLEY HALL MD 4013 BUCKHANNON PIKE MOUNT CLARE WV 26408 833647 0 X WWW.WVMPHP.ORG X 2007 WV TO PROVIDE ASSISTANCE, GUIDANCE AND MONITORING FOR PHYSICIANS, PHYSICIAN ASSISTANTS & PODIATRISTS WITH POTENTIALLY IMPAIRING HEALTH CONDITIONS. 15 14 6 16 394 0 312850 407554 503412 426093 0 0 68703 0 884965 833647 131964 194864 0 0 383781 439843 0 0 24166 263510 253101 779255 887808 105710 -54161 575353 522457 8286 9551 567067 512906 TO PROVIDE ASSISTANCE, GUIDANCE AND MONITORING FOR PHYSICIANS, PHYSICIAN ASSISTANTS & PODIATRISTS WITH POTENTIALLY IMPAIRING HEALTH CONDITIONS. 0 0 815311 194864 425699 REHABILITATION OF PHYSICIANS, SURGEONS AND OTHER HEALTH CARE PROFESSIONALS WITH POTENTIALLY IMPAIRING HEALTH CONCERNS INCLUDING ABUSE OF MOOD ALTERING DRUGS INCLUDING ALCOHOL, MENTAL ILLNESS OR PHYSICAL ILLNESS AFFECTING COMPETENCY SO THAT PHYSICIANS, SURGEONS AND OTHER HEALTH CARE PROFESSIONALS SO AFFLICTED MAY BE TREATED, MONITORED AND RETURNED TO THE SAFE PRACTICE OF THEIR PROFESSION TO THE BENEFIT OF THE HEALTH CARE PROFESSION AND THE PATIENTS THEY SERVE. 815311 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 1 0 0 1 0 0 0 0 0 1 0 0 0 1 4 0 1 6 1 0 0 0 0 0 0 0 0 0 0 X 15 14 1 0 0 0 0 0 0 1 1 0 0 1 1 1 1 0 0 0 0 0 WV X X MARLENE HALL 3049331030 4013 BUCKHANNON PIKE MOUNT CLARE WV 26408 LORENZO PENCE DO DIRECTOR 1.00 X 0 0 0 EDWARD ESKEW DO DIRECTOR 1.00 X 0 0 0 R CURTIS ARNOLD DPM DIRECTOR 1.00 X 0 0 0 STEPHEN WILSON MD DIRECTOR 1.00 X 0 0 0 BRUCE R MARTIN CIC DIRECTOR 1.00 X 0 0 0 CARL R SULLIVAN III MD DIRECTOR 1.00 X 0 0 0 T PINCKNEY MCILWAIN MD DIRECTOR 1.00 X 0 0 0 MARY WARDEN MD DIRECTOR 1.00 X 0 0 0 MICHELE GRINBERG JD DIRECTOR 1.00 X 0 0 0 LINDA BOYD DO DIRECTOR 1.00 X 0 0 0 SUZANNE GHARIB MD DIRECTOR 1.00 X 0 0 0 P BRADLEY HALL MD DIRECTOR 30.00 X 94144 0 19711 HAROLD E PRESTON JR SECRETARY/TREASURER 1.00 X 0 0 0 PAM MOYERS SCOTT PA VICE-CHAIR 1.00 X 0 0 0 JOSEPH B SELBY MD CHAIRMAN 1.00 X 0 0 0 94144 0 19711 0 0 0 0 0 215000 192554 407554 LICENSURE FEES 621400 311850 311850 PARTICIPANT FEES 621400 72985 72985 OTHER INCOME 621400 40864 40864 INTEREST INCOME 621400 338 338 DIVIDEND INCOME 621400 56 56 426093 833647 425699 394 0 X 148564 148564 46300 46300 94144 80022 9415 4707 255122 216854 25512 12756 53051 46607 3791 2653 37526 31897 3753 1876 141294 141294 27503 27503 28800 24480 2880 1440 6950 6950 1513 1513 11441 11441 CONTRACTED SERVICES 20136 20136 TELEPHONE AND UTILITIES 14672 12471 1467 734 OTHER EXPENSES 792 792 887808 815311 48331 24166 569606 518223 25380 21146 5747 4234 575353 522457 8286 9551 8286 9551 X 0 0 0 0 567067 512906 567067 512906 575353 522457 -54161 0 X 1 X 0 0 0 X 207717 281369 332452 381553 407554 1610645 421680 450115 351184 503412 426093 2152484 629397 731484 683636 884965 833647 3763129 0 157100 137478 340987 494096 417359 1547020 157100 137478 340987 494096 417359 1547020 2216109 791 1581 456 462 395 3685 791 1581 456 462 395 3685 630188 733065 684092 885427 834042 3766814 0.58830 0.61530 0.00100 0.00110 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1348 1348 0 24032 19798 4234 4234 1 ADDICTION TRAINING INSTITUTE PO BOX 9137 MORGANTOWN WV 26504 556000842 501(C)(3) 15000 0 TO ASSIST WITH EDUCATING THE HEALTHCARE PROFESSIONAL COMMUNITY AND PUBLIC WITH RESPECT TO SUBSTANCE ABUSE DISORDER APPALACHIAN ADDICTION CONFERENCE 4013 BUCKHANNON PIKE MOUNT CLARE WV 26408 824097876 501(C)(3) 95564 0 TO ASSIST WITH EDUCATING THE HEALTHCARE PROFESSIONAL COMMUNITY AND PUBLIC WITH RESPECT TO SUBSTANCE ABUSE DISORDER WEST VIRGINIA ACADEMY OF FAMILY PHYSICIANS PO BOX 1090 HURRICANE WV 25526 550419533 501(C)(3) 8000 0 TO ASSIST WITH EDUCATING THE HEALTHCARE PROFESSIONAL COMMUNITY AND PUBLIC WITH RESPECT TO SUBSTANCE ABUSE DISORDER WEST VIRGINIA OSTEOPATHIC MEDICAL ASSOCIATION 400 NORTH LEE STREET LEWISBURG WV 24901 550416377 501(C)(3) 10000 0 TO ASSIST WITH EDUCATING THE HEALTHCARE PROFESSIONAL COMMUNITY AND PUBLIC WITH RESPECT TO SUBSTANCE ABUSE DISORDER WEST VIRGINIA STATE MEDICAL ASSOCIATION 2018 KANAWHA BLVD E CHARLESTON WV 25311 550307420 501(C)(6) 20000 0 TO ASSIST WITH EDUCATING THE HEALTHCARE PROFESSIONAL COMMUNITY AND PUBLIC WITH RESPECT TO SUBSTANCE ABUSE DISORDER SCHOLARSHIPS 199 46300 JAMES H BERRY DO BOARD MEMBER 700 SCHOLARSHIP BRADLEY P HALL MD BOARD MEMBER 700 SCHOLARSHIP EDWARD ESKEW DO BOARD MEMBER 700 SCHOLARSHIP MARLENE HALL BOARD MEMBER 215 SCHOLARSHIP RACHEL HALL FAMILY OF BOARD MEMBER 215 SCHOLARSHIP APPALACHIAN ADDICTION CONFERENCE COMMON BOARD MEMBERS 141864 AWARDED A GRANT ADMINISTERED BY THE WVMPHP PROVIDED BY THE WVDHHR TO APPALACHIAN ADDICTION CONFERENCE IN THE AMOUNT OF $141,864. 1 APPALACHIAN ADDICTION CONFERENCE COMMON BOARD MEMBERS 10000 AAC AWARDED A $10,000 GRANT TO WVMPHP 1 FORM 990, PART VI, SECTION A, LINE 2 MEDICAL DIRECTOR P. BRADLEY HALL, MD IS THE HUSBAND OF EMPLOYEE MARLENE D. HALL. FORM 990, PART VI, SECTION B, LINE 11B DURING A BOARD MEETING, THE BOARD OF DIRECTORS WILL REVIEW THE TAX RETURN FOR ANY OBVIOUS ERRORS. FORM 990, PART VI, SECTION B, LINE 12C IF ANYONE IN ATTENDANCE AT A BOARD MEETING HAS A CONFLICT OF INTEREST, THEY REMOVE THEMSELVES FROM VOTING. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION ALLOWS PUBLIC INSPECTION OF FORM 990 UPON REQUEST FORM 990, PART IX, LINE 11G PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 141,294. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 141,294. APPALACHIAN ADDICTION CONFERENCE 4013 BUCKHANNON PIKE MOUNT CLARE WV 26408 824097876 PROVIDE EDUCATION TO HEALTHCARE PROFESSIONALS RELATING TO SUBSTANCE USE WV 501(C)(3) PUBLIC CHARITY 501(C 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 APPALACHIAN ADDICTION CONFERENCE B 141864 CASH APPALACHIAN ADDICTION CONFERENCE C 10000 CASH SERENITY SOLUTIONS LLC M 132000 CASH