| Name: | Whitfield Family Practice LLC |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Professional Limited Liability Company |
| Status: | Exists |
| Date of registration: | 15 Jan 2021 (4 years ago) |
| Entity Number: | 000-829-912 |
| Register Number: | 000829912 |
| County: | Morgan |
| Place of Formation: | Alabama |
| Registered Office Street Address: | 2430 Red Bank Rd SEDecatur, AL 35603 |
| Registered Office Street Address ZIP Code: | 35603 |
| Unique Entity ID | Expiration Date | Physical Address | Mailing Address | |||||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| H6NCUFFH5AL6 | 2022-11-10 | 2430 RED BANK RD SE, DECATUR, AL, 35603, 5028, USA | 2430 RED BANK RD SE, DECATUR, AL, 35603, 5028, USA | |||||||||||||||||||||||||||||||||||||||||||||
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| URL | whitfieldfp.com |
| Division Name | WHITFIELD FAMILY PRACTICE LLC |
| Division Number | WHITFIELD |
| Congressional District | 05 |
| State/Country of Incorporation | AL, USA |
| Activation Date | 2021-08-17 |
| Initial Registration Date | 2021-08-12 |
| Entity Start Date | 2021-01-15 |
| Fiscal Year End Close Date | Dec 31 |
Service Classifications
| NAICS Codes | 621111 |
| Product and Service Codes | Q201, Q509, Q516 |
Points of Contacts
| Electronic Business | |
|---|---|
| Title | PRIMARY POC |
| Name | NATHAN C WHITFIELD |
| Address | 2828 HWY 31 S, SUITE 111, DECATUR, AL, 35603, USA |
| Government Business | |
|---|---|
| Title | PRIMARY POC |
| Name | NATHAN C WHITFIELD |
| Address | 2828 HWY 31 S, SUITE 111, DECATUR, AL, 35603, USA |
| Past Performance | Information not Available |
|---|
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1013507680 | 2021-01-19 | 2023-08-13 | 2828 HIGHWAY 31 S STE 111, DECATUR, AL, 356031538, US | 2828 HIGHWAY 31 S STE 111, DECATUR, AL, 356031538, US | |||||||||||||||||||
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| Phone | +1 256-686-3456 |
| Fax | 2566863519 |
Authorized person
| Name | DR. AMBER JOHNSON WHITFIELD |
| Role | OWNER |
| Phone | 2566863456 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| Is Primary | No |
| Taxonomy Code | 261Q00000X - Clinic/Center |
| Is Primary | Yes |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| WHITFIELD FAMILY PRACTICE 401(K) PLAN | 2023 | 861479992 | 2024-05-17 | WHITFIELD FAMILY PRACTICE LLC | 11 | |||||||||||||||||||||||||||||
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| WHITFIELD FAMILY PRACTICE 401(K) PLAN | 2022 | 861479992 | 2023-05-27 | WHITFIELD FAMILY PRACTICE LLC | 7 | |||||||||||||||||||||||||||||
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| Administrator’s EIN | 474474775 |
| Plan administrator’s name | GUIDELINE, INC. |
| Plan administrator’s address | 1412 CHAPIN AVENUE, BURLINGAME, CA, 94010 |
| Administrator’s telephone number | 8882283491 |
Signature of
| Role | Plan administrator |
| Date | 2023-05-27 |
| Name of individual signing | CHRISTINE RIMER |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2021-06-24 |
| Business code | 621111 |
| Sponsor’s telephone number | 2562147868 |
| Plan sponsor’s address | 2430 RED BANK RD SE, DECATUR, AL, 356035028 |
Plan administrator’s name and address
| Administrator’s EIN | 474474775 |
| Plan administrator’s name | GUIDELINE, INC. |
| Plan administrator’s address | 1645 E 6TH STREET, SUITE 200, AUSTIN, TX, 78702 |
| Administrator’s telephone number | 8882283491 |
Signature of
| Role | Plan administrator |
| Date | 2022-06-02 |
| Name of individual signing | CHRISTINE RIMER |
| Name | Role | Address |
|---|---|---|
| WHITFIELD, NATHANIEL C | Agent | 2430 RED BANK RD SEDECATUR, AL 35603-5028 |
Date of last update: 16 Aug 2024
Sources: Alabama Secretary of State
