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Elizabeth Jacobson, MD, LLC

Details

Name: Elizabeth Jacobson, MD, LLC
Jurisdiction: Alabama
Legal type: Domestic Limited Liability Company
Status: Exists
Date of registration: 02 Oct 2008 (16 years ago)
Entity Number: 000-425-797
Register Number: 000425797
Historical Names: Inverness Dermatology, LLC
County: Shelby
Place of Formation: Jefferson County
Registered Office Street Address: 2001 LAKE HEATHER DRIVEHOOVER, AL 35242
Registered Office Street Address ZIP Code: 35242

Activities DERMATOLOGIC MEDICAL PRACTICE

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1235380213 2008-10-08 2013-03-05 250 INVERNESS CENTER DR, BIRMINGHAM, AL, 352424834, US 250 INVERNESS CENTER DR, BIRMINGHAM, AL, 352424834, US

Contacts
Phone +1 205-995-5575
Fax 2059955576

Authorized person
Name DR. ELIZABETH SANDERS JACOBSON
Role OWNER
Phone 2059955575

Taxonomy
Taxonomy Code 207N00000X - Dermatology Physician
License Number 23689
State AL
Is Primary Yes

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
INVERNESS DERMATOLOGY, LLC 401(K) PROFIT SHARING PLAN 2018 263484689 2019-10-07 INVERNESS DERMATOLOGY, LLC 29
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Business code 621111
Sponsor’s telephone number 2059955572
Plan sponsor’s address 250 INVERNESS CENTER DRIVE, SUITE A, HOOVER, AL, 35242
INVERNESS DERMATOLOGY, LLC 401(K) PROFIT SHARING PLAN 2018 263484689 2019-05-24 INVERNESS DERMATOLOGY, LLC 30
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Business code 621111
Sponsor’s telephone number 2059955575
Plan sponsor’s address 250 INVERNESS CENTER DRIVE, SUITE A, HOOVER, AL, 352424834
INVERNESS DERMATOLOGY, LLC 401(K) PROFIT SHARING PLAN 2017 263484689 2018-09-04 INVERNESS DERMATOLOGY, LLC 16
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Business code 621111
Sponsor’s telephone number 2059955575
Plan sponsor’s address 250 INVERNESS CENTER DRIVE, SUITE A, HOOVER, AL, 352424834
INVERNESS DERMATOLOGY, LLC 401(K) PROFIT SHARING PLAN 2016 263484689 2017-07-17 INVERNESS DERMATOLOGY, LLC 16
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Business code 621111
Sponsor’s telephone number 2059955575
Plan sponsor’s address 250 INVERNESS CENTER DRIVE, SUITE A, HOOVER, AL, 352424834
INVERNESS DERMATOLOGY, LLC CASH BALANCE PLAN 2015 263484689 2016-09-20 INVERNESS DERMATOLOGY, LLC 13
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2011-01-01
Business code 621111
Sponsor’s telephone number 2059955575
Plan sponsor’s address 250 INVERNESS CENTER DRIVE, SUITE A, BIRMINGHAM, AL, 35242

Signature of
Role Plan administrator
Date 2016-09-20
Name of individual signing ELIZABETH S. JACOBSON, M. D.
INVERNESS DERMATOLOGY, LLC 401(K) PROFIT SHARING PLAN 2015 263484689 2016-07-28 INVERNESS DERMATOLOGY, LLC 20
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Business code 621111
Sponsor’s telephone number 2059955575
Plan sponsor’s address 250 INVERNESS CENTER DRIVE, SUITE A, HOOVER, AL, 352424834

Signature of
Role Plan administrator
Date 2016-07-28
Name of individual signing ELIZABETH S. JACOBSON, M.D.
Role Employer/plan sponsor
Date 2016-07-28
Name of individual signing ELIZABETH S. JACOBSON, M.D.
INVERNESS DERMATOLOGY, LLC CASH BALANCE PLAN 2014 263484689 2015-06-08 INVERNESS DERMATOLOGY, LLC 15
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2011-01-01
Business code 621111
Sponsor’s telephone number 2059955575
Plan sponsor’s address 250 INVERNESS CENTER DRIVE, SUITE A, BIRMINGHAM, AL, 35242

Signature of
Role Plan administrator
Date 2015-06-01
Name of individual signing ELIZABETH S. JACOBSON, M. D.
Role Employer/plan sponsor
Date 2015-06-01
Name of individual signing ELIZABETH S. JACOBSON, M. D.
INVERNESS DERMATOLOGY, LLC 401(K) PROFIT SHARING PLAN 2014 263484689 2015-06-01 INVERNESS DERMATOLOGY, LLC 19
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Business code 621111
Sponsor’s telephone number 2059955575
Plan sponsor’s address 250 INVERNESS CENTER DRIVE, SUITE A, HOOVER, AL, 352424834

Signature of
Role Plan administrator
Date 2015-06-01
Name of individual signing ELIZABETH S. JACOBSON, M.D.
Role Employer/plan sponsor
Date 2015-06-01
Name of individual signing ELIZABETH S. JACOBSON, M.D.
INVERNESS DERMATOLOGY, LLC 401(K) PROFIT SHARING PLAN 2013 263484689 2014-06-20 INVERNESS DERMATOLOGY, LLC 17
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Business code 621111
Sponsor’s telephone number 2059955575
Plan sponsor’s address 250 INVERNESS CENTER DRIVE, SUITE A, HOOVER, AL, 352424834

Signature of
Role Plan administrator
Date 2014-06-20
Name of individual signing ELIZABETH S. JACOBSON, M.D.
Role Employer/plan sponsor
Date 2014-06-20
Name of individual signing ELIZABETH S. JACOBSON, M.D.
INVERNESS DERMATOLOGY, LLC CASH BALANCE PLAN 2013 263484689 2014-06-20 INVERNESS DERMATOLOGY, LLC 11
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2011-01-01
Business code 621111
Sponsor’s telephone number 2059955575
Plan sponsor’s address 250 INVERNESS CENTER DRIVE, SUITE A, BIRMINGHAM, AL, 35242

Signature of
Role Plan administrator
Date 2014-06-20
Name of individual signing ELIZABETH S. JACOBSON, M. D.
Role Employer/plan sponsor
Date 2014-06-20
Name of individual signing ELIZABETH S. JACOBSON, M. D.

Agent

Name Role
KEITH S JACOBSON Agent

Member

Name Role Address
JACOBSON, ELIZABETH S Member 4430 VILLAGE GREEN WAYBIRMINGHAM, AL 35226

Events

Event Date Event Type Old Value New Value
2020-05-15 Name Change Inverness Dermatology, LLC Elizabeth Jacobson, MD, LLC

Related by officers

JACOBSON, ELIZABETH S

Grover Farms, LLC KSS Properties, LLC

Related by address

2001 LAKE HEATHER DRIVEHOOVER, AL 35242

Grover Farms, LLC KSS Properties, LLC

Date of last update: 13 Aug 2024

Sources: Alabama Secretary of State

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