Menu
Search icon

Sports Medicine & Orthopedic Specialists, P.C.

Details

Name: Sports Medicine & Orthopedic Specialists, P.C.
Jurisdiction: Alabama
Legal type: Domestic Corporation
Status: Dissolved
Date of registration: 16 Jun 2000 (24 years ago)
Date of dissolution: 15 Dec 2011
Entity Number: 000-210-654
Register Number: 000210654
Historical Names: BSMOS, Inc.
Baptist Sports Medicine & Orthopedic Specialists, P.C.
County: Jefferson
Place of Formation: Jefferson County
Principal Address: BIRMINGHAM, AL
Registered Office Street Address: 880 MONTCLAIR ROAD STE 577BIRMINGHAM, AL 35213
Registered Office Street Address ZIP Code: 35213
Authorized Capital: $20,000

Activities PRACTICE OF MEDICINE

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1033260880 2007-01-16 2011-02-17 880 MONTCLAIR RD, SUITE 577, BIRMINGHAM, AL, 352131972, US 880 MONTCLAIR RD, SUITE 577, BIRMINGHAM, AL, 352131972, US

Contacts
Phone +1 205-595-6757
Fax 2055950472

Authorized person
Name MRS. MANDY PHILLIPS
Role BUSINESS MANAGER
Phone 2055956757

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

Other Provider Identifiers
Issuer JEREMY BURKETT'S NPI#
Number 1992856801
State AL
Issuer CHERIE MINER'S NPI#
Number 1740252444
State AL
Issuer KEVIN BARBERIO'S NPI#
Number 1821285917
State AL
Issuer MEDICARE GROUP LEGACY#
Number I580
State AL
Issuer AMANDA MCANNALLY'S NPI#
Number 1104947712
State AL
Issuer ELIZABETH SWEAT'S NPI#
Number 1366414096
State AL
Issuer SAMUEL GOLDSTEIN'S NPI#
Number 1427020122
State AL
Issuer JASON DAVIDSON'S NPI#
Number 1558412478
State AL
Issuer RENEE RILEY'S NPI#
Number 1881666592
State AL
Issuer TROY STEWART'S NPI#
Number 1003967944
State AL
Issuer EVE SANTIAGO'S NPI#
Number 1134179245
State AL
Issuer MARCUS JEFFERSON'S NPI#
Number 1558512582
State AL
Issuer DR. CASEY'S NPI
Number 1831132083
State AL
Issuer JAMES FLANAGAN'S NPI#
Number 1972576304
State AL
Issuer JENNY HARTZ'S NPI#
Number 1235380270
State AL
Issuer MARY E BUTT'S NPI#
Number 1912171513
State AL
Issuer DENISE GOLDSTEIN'S NPI#
Number 1427020155
State AL

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
SPORTS MEDICINE & ORTHOPEDIC SPECIALISTS, P.C. 401K PROFIT SHARING PLAN 2011 631252411 2012-03-13 SPORTS MEDICINE & ORTHOPEDIC SPECIALISTS, P.C. 28
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2000-10-01
Business code 621111
Sponsor’s telephone number 2059393699
Plan sponsor’s address 805 ST. VINCENTS DR., SUITE 100, BIRMINGHAM, AL, 352051638

Plan administrator’s name and address
Administrator’s EIN 631252411
Plan administrator’s name SPORTS MEDICINE & ORTHOPEDIC SPECIALISTS, P.C.
Plan administrator’s address 805 ST. VINCENTS DR., SUITE 100, BIRMINGHAM, AL, 352051638
Administrator’s telephone number 2059393699

Signature of
Role Plan administrator
Date 2012-02-28
Name of individual signing SAMUEL R. GOLDSTEIN, M.D.
Role Employer/plan sponsor
Date 2012-02-28
Name of individual signing SAMUEL R. GOLDSTEIN, M.D.
SPORTS MEDICINE & ORTHOPEDIC SPECIALISTS, P.C. 401K PROFIT SHARING PLAN 2011 631252411 2012-02-21 SPORTS MEDICINE & ORTHOPEDIC SPECIALISTS, P.C. 28
Three-digit plan number (PN) 001
Effective date of plan 2000-10-01
Business code 621111
Sponsor’s telephone number 2059393699
Plan sponsor’s address 805 ST. VINCENTS DR., SUITE 100, BIRMINGHAM, AL, 352051638

Plan administrator’s name and address
Administrator’s EIN 631252411
Plan administrator’s name SPORTS MEDICINE & ORTHOPEDIC SPECIALISTS, P.C.
Plan administrator’s address 805 ST. VINCENTS DR., SUITE 100, BIRMINGHAM, AL, 352051638
Administrator’s telephone number 2059393699

Signature of
Role Plan administrator
Date 2012-02-03
Name of individual signing SAMUEL R. GOLDSTEIN, M.D.
Role Employer/plan sponsor
Date 2012-02-03
Name of individual signing SAMUEL R. GOLDSTEIN, M.D.
SPORTS MEDICINE & ORTHOPEDIC SPECIALISTS, P.C. 401K PROFIT SHARING PLAN 2011 631252411 2012-02-03 SPORTS MEDICINE & ORTHOPEDIC SPECIALISTS, P.C. 28
Three-digit plan number (PN) 001
Effective date of plan 2000-10-01
Business code 621111
Sponsor’s telephone number 2059393699
Plan sponsor’s address 805 ST. VINCENTS DR., SUITE 100, BIRMINGHAM, AL, 352051638

Plan administrator’s name and address
Administrator’s EIN 631252411
Plan administrator’s name SPORTS MEDICINE & ORTHOPEDIC SPECIALISTS, P.C.
Plan administrator’s address 805 ST. VINCENTS DR., SUITE 100, BIRMINGHAM, AL, 352051638
Administrator’s telephone number 2059393699

Signature of
Role Plan administrator
Date 2012-02-03
Name of individual signing SAMUEL R. GOLDSTEIN, M.D.
Role Employer/plan sponsor
Date 2012-02-03
Name of individual signing SAMUEL R. GOLDSTEIN, M.D.
SPORTS MEDICINE & ORTHOPEDIC SPECIALISTS, P.C. 401K PROFIT SHARING PLAN 2010 631252411 2011-09-29 SPORTS MEDICINE & ORTHOPEDIC SPECIALISTS, P.C. 28
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2000-10-01
Business code 621111
Sponsor’s telephone number 2059393699
Plan sponsor’s address 805 ST. VINCENTS DR., SUITE 100, BIRMINGHAM, AL, 352051638

Plan administrator’s name and address
Administrator’s EIN 631252411
Plan administrator’s name SPORTS MEDICINE & ORTHOPEDIC SPECIALISTS, P.C.
Plan administrator’s address 805 ST. VINCENTS DR., SUITE 100, BIRMINGHAM, AL, 352051638
Administrator’s telephone number 2059393699

Signature of
Role Plan administrator
Date 2011-09-28
Name of individual signing SAMUEL R. GOLDSTEIN, M.D.
Role Employer/plan sponsor
Date 2011-09-28
Name of individual signing SAMUEL R. GOLDSTEIN, M.D.
SPORTS MEDICINE & ORTHOPEDIC SPECIALISTS, P.C. 401K PROFIT SHARING PLAN 2009 631252411 2010-07-22 SPORTS MEDICINE & ORTHOPEDIC SPECIALISTS, P.C. 25
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2000-10-01
Business code 621111
Sponsor’s telephone number 2055956757
Plan sponsor’s address 880 MONTCLAIR ROAD, SUITE 577, BIRMINGHAM, AL, 352131980

Plan administrator’s name and address
Administrator’s EIN 631252411
Plan administrator’s name SPORTS MEDICINE & ORTHOPEDIC SPECIALISTS, P.C.
Plan administrator’s address 880 MONTCLAIR ROAD, SUITE 577, BIRMINGHAM, AL, 352131980
Administrator’s telephone number 2055956757

Signature of
Role Plan administrator
Date 2010-07-22
Name of individual signing SAMUEL R. GOLDSTEIN, M.D.
Role Employer/plan sponsor
Date 2010-07-22
Name of individual signing SAMUEL R. GOLDSTEIN, M.D.

Agent

Name Role Address
GOLDSTEIN, SAMUEL R Agent 806 ST VINCENT'S DRIVEBIRMINGHAM, AL 35205

Incorporator

Name Role Address
LEVITT, RONALD A Incorporator PO BOX 55727BIRMINGHAM, AL 35255-5727

Events

Event Date Event Type Old Value New Value
2006-09-06 Capital Change $15,000 Authorized --- Paid In $20,000 Authorized undefined Paid In
2005-04-14 Name Change Baptist Sports Medicine & Orthopedic Specialists, P.C. Sports Medicine & Orthopedic Specialists, P.C.
2004-06-21 Capital Change $10,000 Authorized --- Paid In $15,000 Authorized --- Paid In
2000-07-25 Name Change BSMOS, Inc. Baptist Sports Medicine & Orthopedic Specialists, P.C.

Related by officers

GOLDSTEIN, SAMUEL R

Samuel R. Goldstein, M.D., P.C. Samuel R. Goldstein, M.D., P.C.

LEVITT, RONALD A

SC Ventures, LLC Seven Oaks Land & Minerals, LLC Shelby OB, LLC A-PMCS Logistics, LLC Fravert Real Estate, LLC Pelican Coast Conservancy, LLC Morris House Owners' Association, Inc. Orinoco Foundation, Inc. Muratta-Womble, Inc. Eye Injury Registry of Alabama, Inc.

Related by address

BIRMINGHAM, AL

A Bonding, Inc. A-1 Moving and Storage Inc. A-1 Products, Inc. A & A Ambulance Service, Incorporated A & A Ash Jewelers, Incorporated AAA Advertising Agency, Inc. AAA Appliance Parts, Inc. AAA Vinyl Auto Tops, Incorporated A & B Furniture Co., Inc. A and D Fence Co., Inc.

Date of last update: 01 Aug 2024

Sources: Alabama Secretary of State

Privacy policy Policy
About us About us
Contacts Contact us

© 2024 alabamacompanysearch.com, Part of Big Data Integrated