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General Surgery Associates, P.C.

Details

Name: General Surgery Associates, P.C.
Jurisdiction: Alabama
Legal type: Domestic Professional Corporation
Status: Exists
Date of registration: 04 Sep 1992 (32 years ago) (Companies founded in September 1992)
Entity Number: 000-151-958
Register Number: 000151958
Historical Names: Richard Patrick Richardson, M.D., P.C.
ZIP code: 35802 (Companies in Madison, 35802)
County: Madison
Place of Formation: Madison County
Principal Address: HUNTSVILLE, AL
Registered Office Street Address: 4704 WHITESBURG DR S SUITE 200HUNTSVILLE, AL 35802
Authorized Capital: $3,000
Paid Share Capital: ----

Activities MEDICINE

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1386684801 2006-06-07 2011-07-14 4704 WHITESBURG DR SE, SUITE 200, HUNTSVILLE, AL, 358021631, US 4704 WHITESBURG DR SE, SUITE 200, HUNTSVILLE, AL, 358021631, US

Contacts
Phone +1 256-880-4510
Fax 2568804512

Authorized person
Name PETER S WILSON
Role VICE PRESIDENT
Phone 2568804510

Taxonomy
Taxonomy Code 208600000X - Surgery Physician
Is Primary Yes

Other Provider Identifiers
Issuer MEDICAID
Number 529502500
State AL
Issuer RAILROAD MEDICARE
Number CC7854
State AL

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
GENERAL SURGERY ASSOCIATES, P.C. PSP & 401(K) PLAN 2023 631075063 2024-07-24 GENERAL SURGERY ASSOCIATES, P.C 27
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1995-01-01
Business code 621111
Sponsor’s telephone number 2563275005
Plan sponsor’s address 4704 WHITESBURG DRIVE, SUITE 200, HUNTSVILLE, AL, 35802

Signature of
Role Plan administrator
Date 2024-07-24
Name of individual signing TINA PARDEN
GENERAL SURGERY ASSOCIATES, P.C. PSP & 401(K) PLAN 2022 631075063 2023-09-22 GENERAL SURGERY ASSOCIATES, P.C 28
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1995-01-01
Business code 621111
Sponsor’s telephone number 2563275005
Plan sponsor’s address 4704 WHITESBURG DRIVE, SUITE 200, HUNTSVILLE, AL, 35802

Signature of
Role Plan administrator
Date 2023-09-22
Name of individual signing TINA PARDEN
GENERAL SURGERY ASSOCIATES, P.C. PSP & 401(K) PLAN 2021 631075063 2022-10-07 GENERAL SURGERY ASSOCIATES, P.C 26
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1995-01-01
Business code 621111
Sponsor’s telephone number 2563275005
Plan sponsor’s address 4704 WHITESBURG DRIVE, SUITE 200, HUNTSVILLE, AL, 35802

Signature of
Role Plan administrator
Date 2022-10-07
Name of individual signing TINA PARDEN
GENERAL SURGERY ASSOCIATES, P.C. PSP & 401(K) PLAN 2020 631075063 2023-09-19 GENERAL SURGERY ASSOCIATES, P.C 23
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1995-01-01
Business code 621111
Sponsor’s telephone number 2563275005
Plan sponsor’s address 4704 WHITESBURG DRIVE, SUITE 200, HUNTSVILLE, AL, 35802

Signature of
Role Plan administrator
Date 2023-09-19
Name of individual signing TINA PARDEN
GENERAL SURGERY ASSOCIATES, P.C. PSP & 401 (K) PLAN 2020 631075063 2021-10-11 GENERAL SURGERY ASSOCIATES, P.C. 23
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1995-01-01
Business code 621111
Sponsor’s telephone number 2563275005
Plan sponsor’s address 4704 WHITESBURG DR SW STE 200, HUNTSVILLE, AL, 358021681

Signature of
Role Plan administrator
Date 2021-10-11
Name of individual signing RENEE DAVIE
GENERAL SURGERY ASSOCIATES PC PSP 2019 631075063 2020-09-24 GENERAL SURGERY ASSOCIATES, P.C 21
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1995-01-01
Business code 621111
Sponsor’s telephone number 2563275005
Plan sponsor’s address 4704 WHITESBURG DR., SUITE 200, HUNTSVILLE, AL, 35802

Signature of
Role Plan administrator
Date 2020-09-24
Name of individual signing RENEE DAVIE
Role Employer/plan sponsor
Date 2020-09-24
Name of individual signing PETER A. VEVON
GENERAL SURGERY ASSOCIATES PC PSP 2018 631075063 2019-09-23 GENERAL SURGERY ASSOCIATES, P.C 20
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1995-01-01
Business code 621111
Sponsor’s telephone number 2563275005
Plan sponsor’s address 4704 WHITESBURG DR., SUITE 200, HUNTSVILLE, AL, 35802

Signature of
Role Plan administrator
Date 2019-09-23
Name of individual signing CARMEN DAVIE
GENERAL SURGERY ASSOCIATES PC PSP 2017 631075063 2018-07-25 GENERAL SURGERY ASSOCIATES, P.C 18
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1995-01-01
Business code 621111
Sponsor’s telephone number 2563275005
Plan sponsor’s address 4704 WHITESBURG DR., SUITE 200, HUNTSVILLE, AL, 35802

Signature of
Role Plan administrator
Date 2018-07-25
Name of individual signing RENEE DAVIE
GENERAL SURGERY ASSOCIATES PC PSP 2016 631075063 2017-10-09 GENERAL SURGERY ASSOCIATES, P.C 20
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1995-01-01
Business code 621111
Sponsor’s telephone number 2563275005
Plan sponsor’s address 4704 WHITESBURG DR., SUITE 200, HUNTSVILLE, AL, 35802

Signature of
Role Plan administrator
Date 2017-10-09
Name of individual signing RENEE DAVIE

Agent

Name Role
MANMOHAN K GHANTA Agent

Incorporator

Name Role
RICHARDSON, RICHARD P MD Incorporator

Events

Event Date Event Type Old Value New Value
2003-11-25 Capital Change $2,000 Authorized ---- Paid In $3,000 Authorized ---- Paid In
1996-12-23 Capital Change $1,000 Authorized ---- Paid In $2,000 Authorized ---- Paid In
1995-07-27 Name Change Richard Patrick Richardson, M.D., P.C. General Surgery Associates, P.C.

Related by officers

MANMOHAN K GHANTA

Madison Medical Realty LLC

Related by address

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Date of last update: 01 Aug 2024

Sources: Alabama Secretary of State

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