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Capital City Gastroenterology, P.C.

Details

Name: Capital City Gastroenterology, P.C.
Jurisdiction: Alabama
Legal type: Domestic Professional Corporation
Status: Exists
Date of registration: 11 Mar 2004 (21 years ago) (Companies founded in March 2004)
Entity Number: 000-234-037
Register Number: 000234037
ZIP code: 36106 (Companies in Montgomery, 36106)
County: Montgomery
Place of Formation: Montgomery County
Principal Address: MONTGOMERY, AL
Registered Office Street Address: 3748 EVEREST DRMONTGOMERY, AL 36106
Authorized Capital: $1,000

Activities MEDICINE PRACTICE

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1073587523 2006-02-13 2019-08-09 4126 CARMICHAEL CT, MONTGOMERY, AL, 361062871, US 4126 CARMICHAEL CT, MONTGOMERY, AL, 361062871, US

Contacts
Phone +1 334-495-2600
Fax 3344952604

Authorized person
Name MRS. CHANDI BUTLER
Role ADMINISTRATOR
Phone 3342399257

Taxonomy
Taxonomy Code 207RG0100X - Gastroenterology Physician
Is Primary Yes

Other Provider Identifiers
Issuer CLIA WAIVER
Number 01D1026965

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
CAPITAL CITY GASTROENTEROLOGY, P.C. 401(K) PROFIT SHARING PLAN 2023 200843727 2024-10-02 CAPITAL CITY GASTROENTEROLOGY, P.C. 27
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-03-11
Business code 621111
Sponsor’s telephone number 3344952600
Plan sponsor’s address 4126 CARMICHAEL COURT, MONTGOMERY, AL, 361062871

Signature of
Role Plan administrator
Date 2024-10-02
Name of individual signing NINA NELSON-GARRETT
Valid signature Filed with authorized/valid electronic signature
CAPITAL CITY GASTROENTEROLOGY, P.C. 401(K) PROFIT SHARING PLAN 2022 200843727 2023-10-10 CAPITAL CITY GASTROENTEROLOGY, P.C. 27
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-03-11
Business code 621111
Sponsor’s telephone number 3344952600
Plan sponsor’s address 4126 CARMICHAEL COURT, MONTGOMERY, AL, 361062871

Signature of
Role Plan administrator
Date 2023-10-10
Name of individual signing NINA NELSON-GARRETT
CAPITAL CITY GASTROENTEROLOGY, P.C. 401(K) PROFIT SHARING PLAN 2021 200843727 2022-10-12 CAPITAL CITY GASTROENTEROLOGY, P.C. 29
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-03-11
Business code 621111
Sponsor’s telephone number 3344952600
Plan sponsor’s address 4126 CARMICHAEL COURT, MONTGOMERY, AL, 361062871

Signature of
Role Plan administrator
Date 2022-10-12
Name of individual signing NINA NELSON-GARRETT
CAPITAL CITY GASTROENTEROLOGY, P.C. 401(K) PROFIT SHARING PLAN 2020 200843727 2021-10-15 CAPITAL CITY GASTROENTEROLOGY, P.C. 22
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-03-11
Business code 621111
Sponsor’s telephone number 3344952600
Plan sponsor’s address 4126 CARMICHAEL COURT, MONTGOMERY, AL, 361062871
CAPITAL CITY GASTROENTEROLOGY, P.C. 401(K) PROFIT SHARING PLAN 2019 200843727 2020-10-15 CAPITAL CITY GASTROENTEROLOGY, P.C. 21
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-03-11
Business code 621111
Sponsor’s telephone number 3344952600
Plan sponsor’s address 4126 CARMICHAEL COURT, MONTGOMERY, AL, 361062871
CAPITAL CITY GASTROENTEROLOGY, P.C. 401(K) PROFIT SHARING PLAN 2018 200843727 2019-10-10 CAPITAL CITY GASTROENTEROLOGY, P.C. 18
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-03-11
Business code 621111
Sponsor’s telephone number 3344952600
Plan sponsor’s address 4126 CARMICHAEL COURT, MONTGOMERY, AL, 361062871
CAPITAL CITY GASTROENTEROLOGY, P.C. 401(K) PROFIT SHARING PLAN 2017 200843727 2018-10-15 CAPITAL CITY GASTROENTEROLOGY, P.C. 15
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-03-11
Business code 621111
Sponsor’s telephone number 3344952600
Plan sponsor’s address 4126 CARMICHAEL COURT, MONTGOMERY, AL, 361062871
CAPITAL CITY GASTROENTEROLOGY, P.C. 401(K) PROFIT SHARING PLAN 2016 200843727 2017-05-17 CAPITAL CITY GASTROENTEROLOGY, P.C. 15
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-03-11
Business code 621111
Sponsor’s telephone number 3344952600
Plan sponsor’s address 4126 CARMICHAEL COURT, MONTGOMERY, AL, 361062871
CAPITAL CITY GASTROENTEROLOGY, P.C. 401(K) PROFIT SHARING PLAN 2015 200843727 2016-05-16 CAPITAL CITY GASTROENTEROLOGY, P.C. 16
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-03-11
Business code 621111
Sponsor’s telephone number 3344952600
Plan sponsor’s address 4126 CARMICHAEL COURT, MONTGOMERY, AL, 361062871
CAPITAL CITY GASTROENTEROLOGY, P.C. 401(K) PROFIT SHARING PLAN 2014 200843727 2015-09-29 CAPITAL CITY GASTROENTEROLOGY, P.C. 16
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-03-11
Business code 621111
Sponsor’s telephone number 3344952600
Plan sponsor’s address 4126 CARMICHAEL COURT, MONTGOMERY, AL, 361062871

Agent

Name Role
ANDERSON, MARK M Agent

Incorporator

Name Role Address
GILPIN, ROBERT E L Incorporator 2660 EASTCHASE LANE STE 300MONTGOMERY, AL 36117

Related by officers

ANDERSON, MARK M

CCG Properties, L.L.C. SECOND WIND LAND COMPANY, LLC

GILPIN, ROBERT E L

4Green Land Services, LLC Ozark Materials, LLC Renfroe Property Holdings, LLC 1975 Lee High School Reunion Gilpin Givhan, PC Brooks Export Co., Inc. A & D Foods - Southeastern Boulevard of Montgomery, Inc. Roy Mason, Inc. Grubbs Builders, Inc. Paragon Construction & Development, Incorporated

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Date of last update: 02 Aug 2024

Sources: Alabama Secretary of State

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