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Birmingham Podiatry, P.C.

Details

Name: Birmingham Podiatry, P.C.
Jurisdiction: Alabama
Legal type: Domestic Professional Corporation
Status: Exists
Date of registration: 03 May 1982 (43 years ago)
Entity Number: 000-087-000
Register Number: 000087000
County: Jefferson
Place of Formation: Jefferson County
Principal Address: BIRMINGHAM, AL
Registered Office Street Address: 805 ST VINCENTS DRIVE, STE 420BIRMINGHAM, AL 35205
Registered Office Street Address ZIP Code: 35205
Authorized Capital: $5,000

Activities PODIATRIC MEDICINE

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1477695013 2007-02-12 2010-02-08 805 ST. VINCENT'S DRIVE, SUITE 420, BIRMINGHAM, AL, 35205, US 805 ST. VINCENT'S DRIVE, SUITE 420, BIRMINGHAM, AL, 352052704, US

Contacts
Phone +1 205-324-8511
Fax 2053240319

Authorized person
Name JOHN L ROBERSON JR.
Role OWNER
Phone 2053248511

Taxonomy
Taxonomy Code 213E00000X - Podiatrist
Is Primary Yes

Other Provider Identifiers
Issuer BLUE CROSS
Number 051514505
Issuer BLUE CROSS
Number 051598947
State AL
Issuer MEDICAID
Number 000070338
State AL
Issuer BLUE CROSS
Number 051070338
Issuer BLUE CROSS
Number 051070353
Issuer MEDICAID
Number 000070353
State AL
Issuer MEDICAID
Number 000070942
State AL
Issuer BLUE CROSS
Number 051070942
Issuer MEDICAID
Number 890009900
State AL
Issuer MEDICAID
Number 1174562755
State AL

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
BIRMINGHAM PODIATRY, P.C. 401(K) PROFIT SHARING PLAN 2023 630826296 2024-07-11 BIRMINGHAM PODIATRY, P.C. 40
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2000-01-01
Business code 621111
Sponsor’s telephone number 2055150538
Plan sponsor’s address 805 ST. VINCENT'S DRIVE, SUITE 420, BIRMINGHAM, AL, 35205

Signature of
Role Plan administrator
Date 2024-07-11
Name of individual signing BRIAN LASKER
BIRMINGHAM PODIATRY, P.C. 401(K) PROFIT SHARING PLAN 2022 630826296 2023-06-29 BIRMINGHAM PODIATRY, P.C. 39
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2000-01-01
Business code 621111
Sponsor’s telephone number 2055150538
Plan sponsor’s address 805 ST. VINCENT'S DRIVE, SUITE 420, BIRMINGHAM, AL, 35205

Signature of
Role Plan administrator
Date 2023-06-29
Name of individual signing BRIAN LASKER
BIRMINGHAM PODIATRY, P.C. 401(K) PROFIT SHARING PLAN 2021 630826296 2022-06-20 BIRMINGHAM PODIATRY, P.C. 37
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2000-01-01
Business code 621111
Sponsor’s telephone number 2055150538
Plan sponsor’s address 805 ST. VINCENT'S DRIVE, SUITE 420, BIRMINGHAM, AL, 35205

Signature of
Role Plan administrator
Date 2022-06-20
Name of individual signing BRIAN LASKER
BIRMINGHAM PODIATRY, P.C. 401(K) PROFIT SHARING PLAN 2020 630826296 2021-08-02 BIRMINGHAM PODIATRY, P.C. 34
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2000-01-01
Business code 621111
Sponsor’s telephone number 2055150538
Plan sponsor’s address 805 ST. VINCENT'S DRIVE, SUITE 420, BIRMINGHAM, AL, 35205

Signature of
Role Plan administrator
Date 2021-08-02
Name of individual signing BRIAN LASKER
BIRMINGHAM PODIATRY, P.C. 401K PROFIT SHARING PLAN 2019 630826296 2020-08-31 BIRMINGHAM PODIATRY, P.C. 33
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2000-01-01
Business code 621111
Sponsor’s telephone number 2053248513
Plan sponsor’s address 805 ST. VINCENT'S DRIVE, SUITE 420, BIRMINGHAM, AL, 35205

Signature of
Role Plan administrator
Date 2020-08-31
Name of individual signing APRIL H THRASHER
BIRMINGHAM PODIATRY, P.C. 401K PROFIT SHARING PLAN 2018 630826296 2019-03-07 BIRMINGHAM PODIATRY, P.C. 38
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2000-01-01
Business code 621111
Sponsor’s telephone number 2053248513
Plan sponsor’s address 805 ST. VINCENT'S DRIVE, SUITE 420, BIRMINGHAM, AL, 35205

Signature of
Role Plan administrator
Date 2019-03-07
Name of individual signing APRIL H THRASHER
BIRMINGHAM PODIATRY, P.C. 401K PROFIT SHARING PLAN 2017 630826296 2018-09-20 BIRMINGHAM PODIATRY, P.C. 35
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2000-01-01
Business code 621111
Sponsor’s telephone number 2053248513
Plan sponsor’s address 805 ST. VINCENT'S DRIVE, SUITE 420, BIRMINGHAM, AL, 35205

Signature of
Role Plan administrator
Date 2018-09-20
Name of individual signing APRIL H THRASHER
BIRMINGHAM PODIATRY, P.C. 401K PROFIT SHARING PLAN 2016 630826296 2017-07-31 BIRMINGHAM PODIATRY, P.C. 37
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2000-01-01
Business code 621111
Sponsor’s telephone number 2053248513
Plan sponsor’s address 805 ST. VINCENT'S DRIVE, SUITE 420, BIRMINGHAM, AL, 35205

Signature of
Role Plan administrator
Date 2017-07-31
Name of individual signing APRIL H. THRASHER
BIRMINGHAM PODIATRY, P.C. 401K PROFIT SHARING PLAN 2015 630826296 2016-06-24 BIRMINGHAM PODIATRY, P.C. 37
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2000-01-01
Business code 621111
Sponsor’s telephone number 2053248513
Plan sponsor’s address 805 ST. VINCENT'S DRIVE, SUITE 420, BIRMINGHAM, AL, 35205

Signature of
Role Plan administrator
Date 2016-06-24
Name of individual signing APRIL H. THRASHER, CMPE
BIRMINGHAM PODIATRY, P.C. 401K PROFIT SHARING PLAN 2014 630826296 2015-07-15 BIRMINGHAM PODIATRY, P.C. 39
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2000-01-01
Business code 621111
Sponsor’s telephone number 2053248513
Plan sponsor’s address 805 ST. VINCENT'S DRIVE, SUITE 420, BIRMINGHAM, AL, 35205

Signature of
Role Plan administrator
Date 2015-07-15
Name of individual signing APRIL H. THRASHER

Agent

Name Role
ROBERSON, JOHN L JR Agent

Incorporator

Name Role Address
GODFRYD, THOMAS S Incorporator No data
CLARK, GEORGE E Incorporator 8325 WALNUT HILL LANE SUITE 225DALLAS, TX 75231
CLARK, WALTER D Incorporator No data

Related by officers

GODFRYD, THOMAS S

George E. Clark/Region 10 APMA Scholarship, Inc. Alabama Podiatric Medical Association

CLARK, GEORGE E

George E. Clark, D.P.M., P.C. Petco Limited

CLARK, WALTER D

George E. Clark/Region 10 APMA Scholarship, Inc. Alabama Podiatric Medical Association

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Date of last update: 31 Jul 2024

Sources: Alabama Secretary of State

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