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South Trace Pediatrics, P.C.

Details

Name: South Trace Pediatrics, P.C.
Jurisdiction: Alabama
Legal type: Domestic Professional Corporation
Status: Dissolved
Date of registration: 04 Oct 1995 (29 years ago) (Companies founded in October 1995)
Date of dissolution: 12 Sep 2019
Entity Number: 000-174-992
Register Number: 000174992
Historical Names: Jeff Malone, M.D., P.C.
ZIP code: 35244 (Companies in Jefferson, 35244)
County: Jefferson
Place of Formation: Jefferson County
Principal Address: BIRMINGHAM, AL
Registered Office Street Address: 5330 STADIUM TRACE STE 150BIRMINGHAM, AL 35244
Authorized Capital: $1,000
Paid Share Capital: ----

Activities PRACTICE OF MEDICINE

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1437207743 2007-01-05 2015-07-14 5356 STADIUM TRACE PKWY, SUITE 200, HOOVER, AL, 352445607, US 5356 STADIUM TRACE PKWY, SUITE 200, HOOVER, AL, 352445607, US

Contacts

Phone +1 205-985-9424
Fax 2059859465

Authorized person

Name DR. JEFFREY A. MALONE
Role PRESIDENT
Phone 2059859424

Taxonomy

Taxonomy Code 261QH0100X - Health Service Clinic/Center
Is Primary Yes

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
SOUTH TRACE PEDIATRICS, P.C. 401K PROFIT SHARING PLAN 2017 631154722 2018-07-13 SOUTH TRACE PEDIATRICS, P.C. 9
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621111
Sponsor’s telephone number 2059859424
Plan sponsor’s address 1134 COUNTRY CLUB CIR, HOOVER, AL, 35244
SOUTH TRACE PEDIATRICS, P.C. 401K PROFIT SHARING PLAN 2016 631154722 2017-07-14 SOUTH TRACE PEDIATRICS, P.C. 11
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621111
Sponsor’s telephone number 2059859424
Plan sponsor’s address 1134 COUNTRY CLUB CIR, HOOVER, AL, 35244

Signature of

Role Plan administrator
Date 2017-07-14
Name of individual signing JEFFREY A. MALONE, M.D.
SOUTH TRACE PEDIATRICS, P.C. 401K PROFIT SHARING PLAN 2015 631154722 2016-06-13 SOUTH TRACE PEDIATRICS, P.C. 11
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621111
Sponsor’s telephone number 2059859424
Plan sponsor’s address 5356 STADIUM TRACE SUITE 200, HOOVER, AL, 352444538

Signature of

Role Plan administrator
Date 2016-06-13
Name of individual signing JEFFREY A. MALONE, M.D.
SOUTH TRACE PEDIATRICS, P.C. 401K PROFIT SHARING PLAN 2014 631154722 2015-07-06 SOUTH TRACE PEDIATRICS, P.C. 11
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621111
Sponsor’s telephone number 2059859424
Plan sponsor’s address 5356 STADIUM TRACE SUITE 200, HOOVER, AL, 352444538

Signature of

Role Plan administrator
Date 2015-07-06
Name of individual signing JEFFREY A. MALONE, M.D.
SOUTH TRACE PEDIATRICS, P.C. 401K PROFIT SHARING PLAN 2013 631154722 2014-07-29 SOUTH TRACE PEDIATRICS, P.C. 12
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621111
Sponsor’s telephone number 2059859424
Plan sponsor’s address 5356 STADIUM TRACE SUITE 200, HOOVER, AL, 352444538

Signature of

Role Plan administrator
Date 2014-07-28
Name of individual signing JEFFREY A. MALONE, M.D.
Role Employer/plan sponsor
Date 2014-07-28
Name of individual signing JEFFREY A. MALONE, M.D.
SOUTH TRACE PEDIATRICS, P.C. 401K PROFIT SHARING PLAN 2012 631154722 2013-07-24 SOUTH TRACE PEDIATRICS, P.C. 10
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621111
Sponsor’s telephone number 2059859424
Plan sponsor’s address 5356 STADIUM TRACE SUITE 200, HOOVER, AL, 352444538

Signature of

Role Plan administrator
Date 2013-07-24
Name of individual signing JEFFREY A. MALONE, M.D.
Role Employer/plan sponsor
Date 2013-07-24
Name of individual signing JEFFREY A. MALONE, M.D.
SOUTH TRACE PEDIATRICS, P.C. 401K PROFIT SHARING PLAN 2011 631154722 2012-03-30 SOUTH TRACE PEDIATRICS, P.C. 10
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621111
Sponsor’s telephone number 2059859424
Plan sponsor’s address 5356 STADIUM TRACE SUITE 200, HOOVER, AL, 352444538

Plan administrator’s name and address

Administrator’s EIN 631154722
Plan administrator’s name SOUTH TRACE PEDIATRICS, P.C.
Plan administrator’s address 5356 STADIUM TRACE SUITE 200, HOOVER, AL, 352444538
Administrator’s telephone number 2059859424

Signature of

Role Plan administrator
Date 2012-03-28
Name of individual signing JEFFREY A. MALONE, M.D.
Role Employer/plan sponsor
Date 2012-03-28
Name of individual signing JEFFREY A. MALONE, M.D.
SOUTH TRACE PEDIATRICS, P.C. 401K PROFIT SHARING PLAN 2010 631154722 2011-10-04 SOUTH TRACE PEDIATRICS, P.C. 9
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621111
Sponsor’s telephone number 2059859424
Plan sponsor’s address 5356 STADIUM TRACE, HOOVER, AL, 352444538

Plan administrator’s name and address

Administrator’s EIN 631154722
Plan administrator’s name SOUTH TRACE PEDIATRICS, P.C.
Plan administrator’s address 5356 STADIUM TRACE, HOOVER, AL, 352444538
Administrator’s telephone number 2059859424

Signature of

Role Plan administrator
Date 2011-10-04
Name of individual signing JEFFREY A. MALONE, M.D.
Role Employer/plan sponsor
Date 2011-10-04
Name of individual signing JEFFREY A. MALONE, M.D.
SOUTH TRACE PEDIATRICS, P.C. 401K PROFIT SHARING PLAN 2009 631154722 2010-07-06 SOUTH TRACE PEDIATRICS, P.C. 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621111
Sponsor’s telephone number 2059859424
Plan sponsor’s address 5330 STADIUM TRACE DRIVE, SUITE 150, BIRMINGHAM, AL, 352444538

Plan administrator’s name and address

Administrator’s EIN 631154722
Plan administrator’s name SOUTH TRACE PEDIATRICS, P.C.
Plan administrator’s address 5330 STADIUM TRACE DRIVE, SUITE 150, BIRMINGHAM, AL, 352444538
Administrator’s telephone number 2059859424

Signature of

Role Plan administrator
Date 2010-07-06
Name of individual signing JEFFREY A. MALONE, M.D.
Role Employer/plan sponsor
Date 2010-07-06
Name of individual signing JEFFREY A. MALONE, M.D.

Agent

Name Role
MALONE, JEFFREY ALLEN Agent

Incorporator

Name Role
MALONE, JEFFREY ALLEN Incorporator

Events

Event Date Event Type Old Value New Value
1997-08-11 Name Change Jeff Malone, M.D., P.C. South Trace Pediatrics, P.C.

Date of last update: 01 Aug 2024

Sources: Alabama Secretary of State