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Alabama Bone and Joint Clinic, LLC

Details

Name: Alabama Bone and Joint Clinic, LLC
Jurisdiction: Alabama
Legal type: Domestic Limited Liability Company
Status: Exists
Date of registration: 01 Feb 2011 (14 years ago)
Entity Number: 000-002-686
Register Number: 000002686
County: Shelby
Place of Formation: Shelby County
Registered Office Street Address: 120 CAHABA VALLEY PARKWAY STE 100PELHAM, AL 35124
Registered Office Street Address ZIP Code: 35124

Activities PROVIDE CLINICAL/EDUCATIONAL/ADMINISTRATIVE

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1780980540 2011-01-26 2011-09-19 1022 1ST ST N, SUITE 220, ALABASTER, AL, 350078706, US 1022 1ST ST N, SUITE 220, ALABASTER, AL, 350078706, US

Contacts

Phone +1 205-621-3778

Authorized person

Name DR. CHAD EVERETT MATHIS
Role DELEGATED OFFICIAL
Phone 2056213778

Taxonomy

Taxonomy Code 207X00000X - Orthopaedic Surgery Physician
License Number 27369
State AL
Is Primary Yes

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
ALABAMA BONE AND JOINT CLINIC RETIREMENT PLAN 2023 274655689 2024-04-26 ALABAMA BONE AND JOINT CLINIC, LLC 35
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2012-01-01
Business code 621111
Sponsor’s telephone number 2056213778
Plan sponsor’s address 120 CAHABA VALLEY PKWY, SUITE 100, PELHAM, AL, 35124

Signature of

Role Plan administrator
Date 2024-04-26
Name of individual signing DARYL DYKES
Role Employer/plan sponsor
Date 2024-04-26
Name of individual signing DARYL DYKES
ALABAMA BONE AND JOINT CLINIC RETIREMENT PLAN 2022 274655689 2023-05-31 ALABAMA BONE AND JOINT CLINIC, LLC 31
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2012-01-01
Business code 621111
Sponsor’s telephone number 2056213778
Plan sponsor’s address 120 CAHABA VALLEY PKWY, SUITE 100, PELHAM, AL, 35124

Signature of

Role Plan administrator
Date 2023-05-31
Name of individual signing DARYL DYKES
ALABAMA BONE AND JOINT CLINIC RETIREMENT PLAN 2021 274655689 2022-06-07 ALABAMA BONE AND JOINT CLINIC, LLC 30
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2012-01-01
Business code 621111
Sponsor’s telephone number 2056213778
Plan sponsor’s address 120 CAHABA VALLEY PKWY, SUITE 100, PELHAM, AL, 35124

Signature of

Role Plan administrator
Date 2022-06-07
Name of individual signing DARYL DYKES
Role Employer/plan sponsor
Date 2022-06-07
Name of individual signing DARYL DYKES
ALABAMA BONE AND JOINT CLINIC RETIREMENT PLAN 2020 274655689 2021-06-17 ALABAMA BONE AND JOINT CLINIC, LLC 33
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2012-01-01
Business code 621111
Sponsor’s telephone number 2056213778
Plan sponsor’s address 120 CAHABA VALLEY PKWY, SUITE 100, PELHAM, AL, 35124

Signature of

Role Plan administrator
Date 2021-06-17
Name of individual signing DARYL DYKES
Role Employer/plan sponsor
Date 2021-06-17
Name of individual signing DARYL DYKES
ALABAMA BONE AND JOINT CLINIC RETIREMENT PLAN 2019 274655689 2020-06-15 ALABAMA BONE AND JOINT CLINIC, LLC 32
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2012-01-01
Business code 621111
Sponsor’s telephone number 2056213778
Plan sponsor’s address 120 CAHABA VALLEY PKWY, SUITE 100, PELHAM, AL, 35124

Signature of

Role Plan administrator
Date 2020-06-15
Name of individual signing DARYL DYKES
Role Employer/plan sponsor
Date 2020-06-15
Name of individual signing DARYL DYKES
ALABAMA BONE AND JOINT CLINIC RETIREMENT PLAN 2018 274655689 2019-09-23 ALABAMA BONE AND JOINT CLINIC, LLC 25
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2012-01-01
Business code 621111
Sponsor’s telephone number 2056213778
Plan sponsor’s address 120 CAHABA VALLEY PKWY, SUITE 100, PELHAM, AL, 35124

Signature of

Role Plan administrator
Date 2019-09-23
Name of individual signing DARYL DYKES
ALABAMA BONE AND JOINT CLINIC RETIREMENT PLAN 2017 274655689 2018-09-25 ALABAMA BONE AND JOINT CLINIC, LLC 22
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2012-01-01
Business code 621111
Sponsor’s telephone number 2056213778
Plan sponsor’s address 120 CAHABA VALLEY PKWY, SUITE 100, PELHAM, AL, 35124

Signature of

Role Plan administrator
Date 2018-09-25
Name of individual signing MARIA FAULKENR
ALABAMA BONE AND JOINT CLINIC RETIREMENT PLAN 2016 274655689 2017-10-11 ALABAMA BONE AND JOINT CLINIC, LLC 23
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2012-01-01
Business code 621111
Sponsor’s telephone number 2056213778
Plan sponsor’s address 120 CAHABA VALLEY PKWY, SUITE 100, PELHAM, AL, 35124

Signature of

Role Plan administrator
Date 2017-10-11
Name of individual signing MARIA FAULKNER
Role Employer/plan sponsor
Date 2017-10-11
Name of individual signing MARIA FAULKNER
ALABAMA BONE AND JOINT CLINIC, LLC RETIREMENT SAVINGS PLAN 2015 274655689 2016-09-26 ALABAMA BONE AND JOINT CLINIC, LLC 21
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2012-01-01
Business code 621111
Sponsor’s telephone number 2056213778
Plan sponsor’s address 120 CAHABA VALLEY PARKWAY SUITE 100, PELHAM, AL, 35124

Signature of

Role Plan administrator
Date 2016-09-26
Name of individual signing MARIA FAULKNER
ALABAMA BONE AND JOINT CLINIC, LLC RETIREMENT SAVINGS PLAN 2014 274655689 2015-09-22 ALABAMA BONE AND JOINT CLINIC, LLC 18
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2012-01-01
Business code 621111
Sponsor’s telephone number 2056213778
Plan sponsor’s address 120 CAHABA VALLEY ROAD, SUITE 100, PELHAM, AL, 35124

Signature of

Role Plan administrator
Date 2015-09-22
Name of individual signing REGINALD NELSON

Agent

Name Role
DYKES, DARYL G Agent

Organizer

Name Role Address
MATHIS, CHAD E Organizer 859 JASMINE HILL ROADINDIAN SPRINGS, AL 35124

Date of last update: 29 Jul 2024

Sources: Alabama Secretary of State