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Eastern Shore Orthopaedic Center, P.C.

Details

Name: Eastern Shore Orthopaedic Center, P.C.
Jurisdiction: Alabama
Legal type: Domestic Professional Corporation
Status: Exists
Date of registration: 17 May 1993 (32 years ago)
Entity Number: 000-156-907
Register Number: 000156907
County: Baldwin
Place of Formation: Baldwin County
Principal Address: FAIRHOPE, AL
Registered Office Street Address: 300 SOUTH GREENO RDFAIRHOPE, AL 36532
Registered Office Street Address ZIP Code: 36532
Authorized Capital: $1,000
Paid Share Capital: $1,000

Activities PRACTICE MEDICINE

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1942408729 2007-07-03 2009-01-13 PO BOX 1212, FAIRHOPE, AL, 365331212, US 912 PLANTATION BLVD, FAIRHOPE, AL, 365322952, US

Contacts

Phone +1 251-928-4033
Fax 2519284032

Authorized person

Name JOHN A RODRIGUEZ-FEO
Role PRESIDENT
Phone 2519284033

Taxonomy

Taxonomy Code 207X00000X - Orthopaedic Surgery Physician
License Number 11349
State AL
Is Primary Yes
Taxonomy Code 225100000X - Physical Therapist
License Number PTH3108
State AL
Is Primary No

Other Provider Identifiers

Issuer MEDICAID
Number 529400020
State AL
Issuer BCBS
Number 51088164
State AL
Issuer BCBS
Number 51094156
State AL

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
EASTERN SHORE ORTHOPAEDIC, P.C. 401(K) PROFIT SHARING PLAN 2023 631091285 2024-10-08 EASTERN SHORE ORTHOPAEDIC CENTER, P.C. 10
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1993-01-01
Business code 621111
Sponsor’s telephone number 2519284033
Plan sponsor’s address 912 PLANTATION BLVD, FAIRHOPE, AL, 36533
EASTERN SHORE ORTHOPAEDIC, P.C. 401(K) PROFIT SHARING PLAN 2022 631091285 2023-06-07 EASTERN SHORE ORTHOPAEDIC CENTER, P.C. 11
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1993-01-01
Business code 621111
Sponsor’s telephone number 2519284033
Plan sponsor’s address 912 PLANTATION BLVD, FAIRHOPE, AL, 36533
EASTERN SHORE ORTHOPAEDIC, P.C. 401(K) PROFIT SHARING PLAN 2021 631091285 2022-10-06 EASTERN SHORE ORTHOPAEDIC CENTER, P.C. 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1993-01-01
Business code 621111
Sponsor’s telephone number 2519284033
Plan sponsor’s address 912 PLANTATION BLVD, FAIRHOPE, AL, 36533
EASTERN SHORE ORTHOPAEDIC, P.C. 401(K) PROFIT SHARING PLAN 2020 631091285 2021-10-11 EASTERN SHORE ORTHOPAEDIC CENTER, P.C. 12
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1993-01-01
Business code 621111
Sponsor’s telephone number 2519284033
Plan sponsor’s address 912 PLANTATION BLVD, FAIRHOPE, AL, 36533
EASTERN SHORE ORTHOPAEDIC, P.C. 401(K)PROFIT SHARING PLAN 2019 631091285 2020-10-05 EASTERN SHORE ORTHOPAEDIC CENTER, P.C. 11
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1993-01-01
Business code 621111
Sponsor’s telephone number 2519284033
Plan sponsor’s address 912 PLANTATION BLVD, FAIRHOPE, AL, 36533

Signature of

Role Plan administrator
Date 2020-10-05
Name of individual signing JOHN A. RODRIGUEZ-FEO MD
Role Employer/plan sponsor
Date 2020-10-05
Name of individual signing JOHN A. RODRIGUEZ-FEO MD
EASTERN SHORE ORTHOPAEDIC, P.C. 401(K)PROFIT SHARING PLAN 2018 631091285 2019-10-23 EASTERN SHORE ORTHOPAEDIC CENTER, P.C. 11
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1993-01-01
Business code 621111
Sponsor’s telephone number 2519284033
Plan sponsor’s address 912 PLANTATION BLVD, FAIRHOPE, AL, 36533

Signature of

Role Plan administrator
Date 2019-10-23
Name of individual signing JOHN RODRIGUEZ-FEO
Role Employer/plan sponsor
Date 2019-10-23
Name of individual signing JOHN RODRIGUEZ-FEO
EASTERN SHORE ORTHOPAEDIC, P.C. 401(K)PROFIT SHARING PLAN 2017 631091285 2018-10-15 EASTERN SHORE ORTHOPAEDIC CENTER, P.C. 11
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1993-01-01
Business code 621111
Sponsor’s telephone number 2519284033
Plan sponsor’s address 912 PLANTATION BLVD, FAIRHOPE, AL, 36533

Signature of

Role Plan administrator
Date 2018-10-15
Name of individual signing JOHN RODRIGUEZ-FEO, MD
Role Employer/plan sponsor
Date 2018-10-15
Name of individual signing JOHN RODRIGUEZ-FEO, MD
EASTERN SHORE ORTHOPAEDIC, P.C. 401(K)PROFIT SHARING PLAN 2016 631091285 2017-10-16 EASTERN SHORE ORTHOPAEDIC CENTER, P.C. 11
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1993-01-01
Business code 621111
Sponsor’s telephone number 2519284033
Plan sponsor’s address 912 PLANTATION BLVD, FAIRHOPE, AL, 36533

Signature of

Role Plan administrator
Date 2017-10-16
Name of individual signing JOHN A. RODRIGUEZ-FEO, MD
Role Employer/plan sponsor
Date 2017-10-16
Name of individual signing JOHN A. RODRIGUEZ-FEO, MD
EASTERN SHORE ORTHOPAEDIC, P.C. 401(K)PROFIT SHARING PLAN 2015 631091285 2016-10-14 EASTERN SHORE ORTHOPAEDIC CENTER, P.C. 11
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1993-01-01
Business code 621111
Sponsor’s telephone number 2519284033
Plan sponsor’s address 912 PLANTATION BLVD, FAIRHOPE, AL, 36533

Signature of

Role Plan administrator
Date 2016-10-14
Name of individual signing JOHN A. RODRIGUEZ-FEO, MD
Role Employer/plan sponsor
Date 2016-10-14
Name of individual signing JOHN A. RODRIGUEZ-FEO, MD
EASTERN SHORE ORTHOPAEDIC CENTER, P.C. PROFIT SHARING PLAN 2014 631091285 2015-09-25 EASTERN SHORE ORTHOPAEDIC CENTER, P.C. 11
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1993-01-01
Business code 621111
Sponsor’s telephone number 2519284033
Plan sponsor’s address 912 PLANTATION BLVD, FAIRHOPE, AL, 36533

Signature of

Role Plan administrator
Date 2015-09-25
Name of individual signing JOHN A. RODRIGUEZ-FEO, MD
Role Employer/plan sponsor
Date 2015-09-25
Name of individual signing JOHN A. RODRIGUEZ-FEO, MD

Agent

Name Role
RODRIGUEZ FEO, JOHN A Agent

Incorporator

Name Role
RODRIGUEZ FEO, JOHN A DR Incorporator

Date of last update: 01 Aug 2024

Sources: Alabama Secretary of State