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Birmingham Heart Clinic, PLLC

Details

Name: Birmingham Heart Clinic, PLLC
Jurisdiction: Alabama
Legal type: Domestic Professional Limited Liability Company
Status: Exists
Date of registration: 03 Jun 1994 (30 years ago) (Companies founded in June 1994)
Entity Number: 000-164-669
Register Number: 000164669
Historical Names: Michael T. Simpson, M.D., P.C.
Birmingham Heart Clinic, P.C.
ZIP code: 35235 (Companies in Jefferson, 35235)
County: Jefferson
Place of Formation: Jefferson County
Principal Address: 100 PILOT MEDICAL DRIVE, SUITE 300BIRMINGHAM, AL 35235
Registered Office Street Address: 641 SOUTH LAWRENCE STREETMONTGOMERY, AL 36104

Activities ANY LAWFUL ACTIVITY

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1508932583 2006-11-28 2016-02-25 100 PILOT MEDICAL DRIVE, SUITE 300, BIRMINGHAM, AL, 352353412, US 100 PILOT MEDICAL DRIVE, SUITE 300, BIRMINGHAM, AL, 352353412, US

Contacts
Phone +1 205-856-2284
Fax 2058154777

Authorized person
Name MS. PAM WYNN
Role OFFICE MANAGER
Phone 2058154810

Taxonomy
Taxonomy Code 174400000X - Specialist
License Number 00006973
State AL
Is Primary Yes

Other Provider Identifiers
Issuer RRMC
Number CC5229
State AL
Issuer MEDICAID
Number 529602240
State AL

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
BIRMINGHAM HEART CLINIC CAFETERIA PLAN 2023 631119002 2024-10-15 BIRMINGHAM HEART CLINIC, P.C. 132
File View Page
Three-digit plan number (PN) 502
Effective date of plan 2014-01-01
Business code 621111
Sponsor’s telephone number 2058562284
Plan sponsor’s mailing address 100 PILOT MEDICAL DRIVE, SUITE 300, BIRMINGHAM, AL, 35235
Plan sponsor’s address 100 PILOT MEDICAL DRIVE, SUITE 300, BIRMINGHAM, AL, 35235

Number of participants as of the end of the plan year
Active participants 117
BIRMINGHAM HEART CLINIC CAFETERIA PLAN 2022 631119002 2023-10-11 BIRMINGHAM HEART CLINIC, P.C. 135
File View Page
Three-digit plan number (PN) 502
Effective date of plan 2014-01-01
Business code 621111
Sponsor’s telephone number 2058562284
Plan sponsor’s mailing address 100 PILOT MEDICAL DRIVE, SUITE 300, BIRMINGHAM, AL, 35235
Plan sponsor’s address 100 PILOT MEDICAL DRIVE, SUITE 300, BIRMINGHAM, AL, 35235

Number of participants as of the end of the plan year
Active participants 121
BIRMINGHAM HEART CLINIC CAFETERIA PLAN 2021 631119002 2022-07-20 BIRMINGHAM HEART CLINIC, P.C. 130
File View Page
Three-digit plan number (PN) 502
Effective date of plan 2014-01-01
Business code 621111
Sponsor’s telephone number 2058562284
Plan sponsor’s mailing address 100 PILOT MEDICAL DRIVE, SUITE 300, BIRMINGHAM, AL, 35235
Plan sponsor’s address 100 PILOT MEDICAL DRIVE, SUITE 300, BIRMINGHAM, AL, 35235

Number of participants as of the end of the plan year
Active participants 120
BIRMINGHAM HEART CLINIC CAFETERIA PLAN 2020 631119002 2021-07-26 BIRMINGHAM HEART CLINIC, P.C. 127
File View Page
Three-digit plan number (PN) 502
Effective date of plan 2014-01-01
Business code 621111
Sponsor’s telephone number 2058562284
Plan sponsor’s mailing address 100 PILOT MEDICAL DRIVE, SUITE 300, BIRMINGHAM, AL, 35235
Plan sponsor’s address 100 PILOT MEDICAL DRIVE, SUITE 300, BIRMINGHAM, AL, 35235

Number of participants as of the end of the plan year
Active participants 116
BIRMINGHAM HEART CLINIC CAFETERIA PLAN 2019 631119002 2020-07-27 BIRMINGHAM HEART CLINIC, P.C. 126
File View Page
Three-digit plan number (PN) 502
Effective date of plan 2014-01-01
Business code 621111
Sponsor’s telephone number 2058562284
Plan sponsor’s mailing address 100 PILOT MEDICAL DRIVE, SUITE 300, BIRMINGHAM, AL, 35235
Plan sponsor’s address 100 PILOT MEDICAL DRIVE, SUITE 300, BIRMINGHAM, AL, 35235

Number of participants as of the end of the plan year
Active participants 118
BIRMINGHAM HEART CLINIC CAFETERIA PLAN 2018 631119002 2020-07-27 BIRMINGHAM HEART CLINIC, P.C. 124
File View Page
Three-digit plan number (PN) 502
Effective date of plan 2014-01-01
Business code 621111
Sponsor’s telephone number 2058562284
Plan sponsor’s mailing address 100 PILOT MEDICAL DRIVE, SUITE 300, BIRMINGHAM, AL, 35235
Plan sponsor’s address 100 PILOT MEDICAL DRIVE, SUITE 300, BIRMINGHAM, AL, 35235

Number of participants as of the end of the plan year
Active participants 110
THE BIRMINGHAM HEART CLINIC, P. C. PROFIT SHARING PLAN 2017 631119002 2018-06-22 BIRMINGHAM HEART CLINIC, P.C. 81
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1994-06-03
Business code 621111
Sponsor’s telephone number 2058154800
Plan sponsor’s address 100 PILOT MEDICAL DRIVE, SUITE 300, BIRMINGHAM, AL, 35235

Signature of
Role Plan administrator
Date 2018-06-22
Name of individual signing VAN REEDER
THE BIRMINGHAM HEART CLINIC, P. C. PROFIT SHARING PLAN 2016 631119002 2017-09-27 BIRMINGHAM HEART CLINIC, P.C. 67
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1994-06-03
Business code 621111
Sponsor’s telephone number 2058154800
Plan sponsor’s address 100 PILOT MEDICAL DRIVE, SUITE 300, BIRMINGHAM, AL, 35235

Signature of
Role Plan administrator
Date 2017-09-27
Name of individual signing MICHAEL SIMPSON
THE BIRMINGHAM HEART CLINIC, P. C. PROFIT SHARING PLAN 2015 631119002 2016-07-15 BIRMINGHAM HEART CLINIC, P.C. 64
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1994-06-03
Business code 621111
Sponsor’s telephone number 2058154800
Plan sponsor’s address 100 PILOT MEDICAL DRIVE, SUITE 300, BIRMINGHAM, AL, 35235

Signature of
Role Plan administrator
Date 2016-07-15
Name of individual signing MICHAEL SIMPSON
THE BIRMINGHAM HEART CLINIC, P. C. PROFIT SHARING PLAN 2014 631119002 2015-07-08 BIRMINGHAM HEART CLINIC, P.C. 61
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1994-06-03
Business code 621111
Sponsor’s telephone number 2058154800
Plan sponsor’s address 100 PILOT MEDICAL DRIVE, SUITE 300, BIRMINGHAM, AL, 35235

Signature of
Role Plan administrator
Date 2015-07-08
Name of individual signing MICHAEL SIMPSON
Role Employer/plan sponsor
Date 2015-07-08
Name of individual signing MICHAEL SIMPSON

Agent

Name Role
CORPORATION SERVICE COMPANY, INC Agent

Member

Name Role Address
USHV AL MANAGEMENT, INC Member 341 COOL SPRINGS BOULEVARD, SUITE 305FRANKLIN, TN 37067

Events

Event Date Event Type Old Value New Value
2024-07-23 Name Change Birmingham Heart Clinic, P.C. Birmingham Heart Clinic, PLLC
1996-08-19 Name Change Michael T. Simpson, M.D., P.C. Birmingham Heart Clinic, P.C.

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CORPORATION SERVICE COMPANY, INC

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641 SOUTH LAWRENCE STREETMONTGOMERY, AL 36104

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Date of last update: 01 Aug 2024

Sources: Alabama Secretary of State

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