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OrthoSports Athens LLC

Details

Name: OrthoSports Athens LLC
Jurisdiction: Alabama
Legal type: Domestic Limited Liability Company
Status: Exists
Date of registration: 01 Aug 2011 (13 years ago)
Entity Number: 000-021-124
Register Number: 000021124
County: Marion
Place of Formation: Marion County
Registered Office Street Address: 1860 US HWY 43WINFIELD, AL 35594
Registered Office Street Address ZIP Code: 35594

Activities ANY AND ALL LAWFUL ACTIVITY

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1659715803 2013-04-18 2013-04-18 1860 US HIGHWAY 43, WINFIELD, AL, 355945062, US 42030 HIGHWAY 195, SUITE A, HALEYVILLE, AL, 355657054, US

Contacts
Phone +1 205-487-1111
Fax 2054871114
Phone +1 205-485-7248
Fax 2054857249

Authorized person
Name MR. JOSEPH PATRICK BOYETT
Role MEMBER/OWNER
Phone 2562332332

Taxonomy
Taxonomy Code 207X00000X - Orthopaedic Surgery Physician
Is Primary Yes

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
ORTHOSPORTS ATHENS, LLC 401(K) PLAN 2019 452827135 2020-04-24 ORTHOSPORTS ATHENS, LLC 17
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-01-01
Business code 621111
Sponsor’s telephone number 2054871111
Plan sponsor’s address 1860 US HIGHWAY 43, WINFIELD, AL, 355945062

Signature of
Role Plan administrator
Date 2020-04-24
Name of individual signing WILL HOLLEY
Role Employer/plan sponsor
Date 2020-04-24
Name of individual signing WILL HOLLEY
ORTHOSPORTS ATHENS, LLC 401(K) PLAN 2018 452827135 2019-10-02 ORTHOSPORTS ATHENS, LLC 20
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-01-01
Business code 621111
Sponsor’s telephone number 2054871111
Plan sponsor’s address 1860 US HIGHWAY 43, WINFIELD, AL, 355945062

Signature of
Role Plan administrator
Date 2019-10-02
Name of individual signing WILL HOLLEY
Role Employer/plan sponsor
Date 2019-10-02
Name of individual signing WILL HOLLEY
ORTHOSPORTS ATHENS, LLC 401(K) PLAN 2017 452827135 2018-04-23 ORTHOSPORTS ATHENS, LLC 21
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-01-01
Business code 621111
Sponsor’s telephone number 2054871111
Plan sponsor’s address 1860 US HIGHWAY 43, WINFIELD, AL, 355945062

Signature of
Role Plan administrator
Date 2018-04-23
Name of individual signing KATHERINE HURT
Role Employer/plan sponsor
Date 2018-04-23
Name of individual signing KATHERINE HURT
ORTHOSPORTS ATHENS, LLC 401(K) PLAN 2016 452827135 2017-07-03 ORTHOSPORTS ATHENS, LLC 18
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-01-01
Business code 621111
Sponsor’s telephone number 2054871111
Plan sponsor’s address 1860 US HIGHWAY 43, WINFIELD, AL, 355945062

Signature of
Role Plan administrator
Date 2017-07-03
Name of individual signing KATHERINE HURT
Role Employer/plan sponsor
Date 2017-07-03
Name of individual signing KATHERINE HURT
ORTHOSPORTS ATHENS, LLC 401(K) PLAN 2015 452827135 2017-05-22 ORTHOSPORTS ATHENS, LLC 16
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-01-01
Business code 621111
Sponsor’s telephone number 2054871111
Plan sponsor’s address 1860 US HIGHWAY 43, WINFIELD, AL, 355945062

Signature of
Role Plan administrator
Date 2017-05-22
Name of individual signing KATHY HURT
Role Employer/plan sponsor
Date 2017-05-22
Name of individual signing KATHY HURT
ORTHOSPORTS ATHENS, LLC 401(K) PLAN 2014 452827135 2015-10-08 ORTHOSPORTS ATHENS, LLC 11
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-01-01
Business code 621111
Sponsor’s telephone number 2054871111
Plan sponsor’s address 1860 US HIGHWAY 43, WINFIELD, AL, 355945062

Signature of
Role Plan administrator
Date 2015-10-08
Name of individual signing KATHY HURT
Role Employer/plan sponsor
Date 2015-10-08
Name of individual signing KATHY HURT

Organizer

Name Role Address
BOYETT, JOESPH PATRICK Organizer 1860 US HWY 43WINFIELD, AL 35594
LAWRENCE, WILLIAM DAVID Organizer 14128 MUIRFIELD DRIVEATHENS, AL 35613

Agent

Name Role
BOYETT, JOESPH P Agent

Related by officers

LAWRENCE, WILLIAM DAVID

Premier OrthoSports Inc OrthoSports Enterprises, L.L.C.

Related by address

1860 US HWY 43WINFIELD, AL 35594

Premier OrthoSports Inc

Date of last update: 30 Jul 2024

Sources: Alabama Secretary of State

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