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Cullman Regional Orthopedics & Sports Medicine, P.C.

Details

Name: Cullman Regional Orthopedics & Sports Medicine, P.C.
Jurisdiction: Alabama
Legal type: Domestic Professional Corporation
Status: Exists
Date of registration: 17 Nov 1995 (29 years ago)
Entity Number: 000-175-648
Register Number: 000175648
County: Cullman
Place of Formation: Cullman County
Principal Address: CULLMAN, AL
Registered Office Street Address: 2021 ALABAMA HWY 157CULLMAN, AL 35055
Registered Office Street Address ZIP Code: 35055
Authorized Capital: $10,000
Paid Share Capital: ----

Activities PRACTICE OF MEDICINE

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1528006996 2006-06-04 2008-03-04 PO BOX 870, CULLMAN, AL, 350560870, US 1942 AL HIGHWAY 157, CULLMAN, AL, 350580609, US

Contacts
Phone +1 256-737-5115

Authorized person
Name DAVID J DUELAND
Role OWNER/PHYSICIAN
Phone 2567375115

Taxonomy
Taxonomy Code 207X00000X - Orthopaedic Surgery Physician
Is Primary Yes

Other Provider Identifiers
Issuer RAILROAD MEDICARE
Number CG0253
State AL

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
RETIREMENT INCOME SECURITY PLAN-CULLMAN REGIONAL ORTHOPEDICS & SPORTS MEDICINE, P.C. 2023 631157261 2024-08-02 CULLMAN REGIONAL ORTHOPEDICS & SPORTS MEDICINE, P.C. 16
Three-digit plan number (PN) 001
Effective date of plan 2008-01-01
Business code 621399
Sponsor’s telephone number 2567375115
Plan sponsor’s address 1942 ALABAMA HIGHWAY 157, SUITE 1, CULLMAN, AL, 35058

Plan administrator’s name and address
Administrator’s EIN 821222973
Plan administrator’s name HEALTHEQUITY RETIREMENT SERVICES, LLC
Plan administrator’s address 15 W SCENIC POINTE DR., STE 100, DRAPER, UT, 84020
Administrator’s telephone number 8778602664

Signature of
Role Plan administrator
Date 2024-08-02
Name of individual signing STEVEN STOUT
RETIREMENT INCOME SECURITY PLAN-CULLMAN REGIONAL ORTHOPEDICS & SPORTS MEDICINE, P.C. 2023 631157261 2024-08-20 CULLMAN REGIONAL ORTHOPEDICS & SPORTS MEDICINE, P.C. 16
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-01-01
Business code 621399
Sponsor’s telephone number 2567375115
Plan sponsor’s address 1942 ALABAMA HIGHWAY 157, SUITE 1, CULLMAN, AL, 35058

Plan administrator’s name and address
Administrator’s EIN 821222973
Plan administrator’s name HEALTHEQUITY RETIREMENT SERVICES, LLC
Plan administrator’s address 15 W SCENIC POINTE DR., STE 100, DRAPER, UT, 84020
Administrator’s telephone number 8778602664

Signature of
Role Plan administrator
Date 2024-08-20
Name of individual signing STEVEN STOUT
RETIREMENT INCOME SECURITY PLAN-CULLMAN REGIONAL ORTHOPEDICS & SPORTS MEDICINE, P.C. 2022 631157261 2023-07-24 CULLMAN REGIONAL ORTHOPEDICS & SPORTS MEDICINE, P.C. 13
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-01-01
Business code 621399
Sponsor’s telephone number 2567375115
Plan sponsor’s address 1942 ALABAMA HIGHWAY 157, SUITE 1, CULLMAN, AL, 35058

Plan administrator’s name and address
Administrator’s EIN 821222973
Plan administrator’s name HEALTHEQUITY RETIREMENT SERVICES, LLC
Plan administrator’s address 15 W SCENIC POINTE DR., STE 100, DRAPER, UT, 84020
Administrator’s telephone number 8778602664

Signature of
Role Plan administrator
Date 2023-07-24
Name of individual signing STEVEN STOUT
RETIREMENT INCOME SECURITY PLAN-CULLMAN REGIONAL ORTHOPEDICS & SPORTS MEDICINE, P.C. 2021 631157261 2022-07-26 CULLMAN REGIONAL ORTHOPEDICS & SPORTS MEDICINE, P.C. 19
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-01-01
Business code 621399
Sponsor’s telephone number 2567375115
Plan sponsor’s address 1942 ALABAMA HIGHWAY 157, SUITE 1, CULLMAN, AL, 35058

Plan administrator’s name and address
Administrator’s EIN 821222973
Plan administrator’s name HEALTHEQUITY RETIREMENT SERVICES, LLC
Plan administrator’s address 15 W SCENIC POINTE DR., STE 100, DRAPER, UT, 84020
Administrator’s telephone number 8778602664

Signature of
Role Plan administrator
Date 2022-07-26
Name of individual signing STEVEN STOUT
RETIREMENT INCOME SECURITY PLAN-CULLMAN REGIONAL ORTHOPEDICS & SPORTS MEDICINE, P.C. 2020 631157261 2021-07-22 CULLMAN REGIONAL ORTHOPEDICS & SPORTS MEDICINE, P.C. 17
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-01-01
Business code 621399
Sponsor’s telephone number 2567375115
Plan sponsor’s address 1942 ALABAMA HIGHWAY 157, SUITE 1, CULLMAN, AL, 35058

Plan administrator’s name and address
Administrator’s EIN 821222973
Plan administrator’s name HEALTHEQUITY RETIREMENT SERVICES, LLC
Plan administrator’s address 15 W SCENIC POINTE DR., STE 100, DRAPER, UT, 84020
Administrator’s telephone number 8778602664

Signature of
Role Plan administrator
Date 2021-07-22
Name of individual signing STEVEN STOUT
RETIREMENT INCOME SECURITY PLAN-CULLMAN REGIONAL ORTHOPEDICS & SPORTS MEDICINE, P.C. 2019 631157261 2020-09-29 CULLMAN REGIONAL ORTHOPEDICS & SPORTS MEDICINE, P.C. 16
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-01-01
Business code 621399
Sponsor’s telephone number 2567375115
Plan sponsor’s address 1942 ALABAMA HIGHWAY 157, SUITE 1, CULLMAN, AL, 35058

Plan administrator’s name and address
Administrator’s EIN 821222973
Plan administrator’s name HEALTHEQUITY RETIREMENT SERVICES, LLC
Plan administrator’s address 15 W SCENIC POINTE DR., STE 100, DRAPER, UT, 84020
Administrator’s telephone number 8778602664

Signature of
Role Plan administrator
Date 2020-09-29
Name of individual signing STEVEN STOUT
RETIREMENT INCOME SECURITY PLAN-CULLMAN REGIONAL ORTHOPEDICS & SPORTS MEDICINE, P.C. 2018 631157261 2019-09-30 CULLMAN REGIONAL ORTHOPEDICS & SPORTS MEDICINE, P.C. 18
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-01-01
Business code 621399
Sponsor’s telephone number 2567375115
Plan sponsor’s address 1942 ALABAMA HIGHWAY 157, SUITE 1, CULLMAN, AL, 35058

Plan administrator’s name and address
Administrator’s EIN 821222973
Plan administrator’s name HEALTHEQUITY RETIREMENT SERVICES, LLC
Plan administrator’s address 15 W SCENIC POINTE DR., STE 100, DRAPER, UT, 84020
Administrator’s telephone number 8778602664

Signature of
Role Plan administrator
Date 2019-09-30
Name of individual signing STEVEN STOUT
RETIREMENT INCOME SECURITY PLAN-CULLMAN REGIONAL ORTHOPEDICS & SPORTS MEDICINE, P.C. 2017 631157261 2018-10-15 CULLMAN REGIONAL ORTHOPEDICS & SPORTS MEDICINE, P.C. 14
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2008-01-01
Business code 621399
Sponsor’s telephone number 2567375115
Plan sponsor’s address 1942 ALABAMA HIGHWAY 157, SUITE 1, CULLMAN, AL, 35058

Plan administrator’s name and address
Administrator’s EIN 821222973
Plan administrator’s name HEALTHEQUITY RETIREMENT SERVICES, LLC
Plan administrator’s address 15 W SCENIC POINTE DR., STE 100, DRAPER, UT, 84020
Administrator’s telephone number 8778602664

Signature of
Role Plan administrator
Date 2018-10-15
Name of individual signing SPENCER BARCLAY
CULLMAN REGIONAL ORTHOPEDICS & SPORTS MEDICINE, P.C. CASH BALANCE PLAN 2017 631157261 2018-10-08 CULLMAN REGIONAL ORTHOPEDICS & SPORTS MEDICINE, P.C. 18
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2006-01-01
Business code 621340
Sponsor’s telephone number 2567375115
Plan sponsor’s address 1942 ALABAMA HWY. 157, SUITE 1, CULLMAN, AL, 35058
CULLMAN REGIONAL ORTHOPEDICS & SPORTS MEDICINE, P.C. CASH BALANCE PLAN 2016 631157261 2017-10-04 CULLMAN REGIONAL ORTHOPEDICS & SPORTS MEDICINE, P.C. 17
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2006-01-01
Business code 621340
Sponsor’s telephone number 2567375115
Plan sponsor’s address 1942 ALABAMA HWY. 157, SUITE 1, CULLMAN, AL, 35058

Agent

Name Role
DUELAND, DAVID J Agent

Incorporator

Name Role
DUELAND, DAVID J Incorporator

Related by officers

DUELAND, DAVID J

CROSM Realty, LLC

Related by address

CULLMAN, AL

The A. A. A. Pest Control, Inc. Alabama Feed Service, Inc. Alabama Poultry Supply Co., Inc. Benefield Brothers, Incorporated Bennett Tire Service, Inc. Brindlee Mountain Development Corporation Buchmann Tire & Retreading, Inc. Builders & Traders, Inc. Central Grocery Company of Cullman Incorporated W. C. Chapman Poultry and Produce, Inc.

Date of last update: 01 Aug 2024

Sources: Alabama Secretary of State

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