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  5. JACKSON CARDIOLOGY ASSOCIATES, P. A.

JACKSON CARDIOLOGY ASSOCIATES, P. A.

Company Details

Name: JACKSON CARDIOLOGY ASSOCIATES, P. A.
Jurisdiction: MISSISSIPPI
Business Type: Profit Corporation
Status: Dissolved
Effective Date: 24 Mar 1980 (45 years ago)
Business ID: 109131
ZIP code: 39213
County: Hinds
State of Incorporation: MISSISSIPPI
Principal Office Address: 6501 Dogwood View Parkway, Suite CJackson, MS 39213

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
JACKSON CARDIOLOGY ASSOCIATES, P. A. PROFIT SHARING 401(K) PLAN 2017 640639841 2018-08-17 JACKSON CARDIOLOGY ASSOCIATES, P.A. 26
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2002-01-01
Business code 621111
Sponsor’s telephone number 6019818543
Plan sponsor’s address 971 LAKELAND DRIVE, STE. 850, JACKSON, MS, 39216

Signature of
Role Plan administrator
Date 2018-08-17
Name of individual signing MALCOLM TAYLOR, M.D.
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2018-08-17
Name of individual signing MALCOLM TAYLOR, M.D.
Valid signature Filed with authorized/valid electronic signature
JACKSON CARDIOLOGY ASSOCIATES, P.A. PROFIT SHARING 401(K) PLAN 2017 640639841 2018-04-09 JACKSON CARDIOLOGY ASSOCIATES, P.A. 27
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2002-01-01
Business code 621111
Sponsor’s telephone number 6019818543
Plan sponsor’s address 971 LAKELAND DRIVE, STE. 850, JACKSON, MS, 39216

Signature of
Role Plan administrator
Date 2018-04-09
Name of individual signing MALCOLM TAYLOR, M.D.
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2018-04-09
Name of individual signing MALCOLM TAYLOR, M.D.
Valid signature Filed with authorized/valid electronic signature
JACKSON CARDIOLOGY ASSOCIATES, P.A. PROFIT SHARING 401(K) PLAN 2016 640639841 2017-06-27 JACKSON CARDIOLOGY ASSOCIATES, P.A. 28
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2002-01-01
Business code 621111
Sponsor’s telephone number 6019818543
Plan sponsor’s address 971 LAKELAND DRIVE, STE. 850, JACKSON, MS, 39216

Signature of
Role Plan administrator
Date 2017-06-27
Name of individual signing TELLIS ELLIS, III
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2017-06-27
Name of individual signing TELLIS ELLIS, III
Valid signature Filed with authorized/valid electronic signature
JACKSON CARDIOLOGY ASSOCIATES, P.A. PROFIT SHARING 401(K) PLAN 2015 640639841 2016-06-23 JACKSON CARDIOLOGY ASSOCIATES, P.A. 28
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2002-01-01
Business code 621111
Sponsor’s telephone number 6019818543
Plan sponsor’s address 971 LAKELAND DRIVE, STE. 850, JACKSON, MS, 39216

Signature of
Role Plan administrator
Date 2016-06-22
Name of individual signing TELLIS ELLIS, III
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2016-06-22
Name of individual signing TELLIS ELLIS, III
Valid signature Filed with authorized/valid electronic signature
JACKSON CARDIOLOGY ASSOCIATES, P.A. PROFIT SHARING 401(K) PLAN 2014 640639841 2015-09-14 JACKSON CARDIOLOGY ASSOCIATES, P.A. 30
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2002-01-01
Business code 621111
Sponsor’s telephone number 6019818543
Plan sponsor’s address 971 LAKELAND DRIVE, STE. 850, JACKSON, MS, 39216

Signature of
Role Plan administrator
Date 2015-09-14
Name of individual signing TELLIS ELLIS, III
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2015-09-14
Name of individual signing TELLIS ELLIS, III
Valid signature Filed with authorized/valid electronic signature
JACKSON CARDIOLOGY ASSOCIATES, P.A. PROFIT SHARIN 401(K) PLAN 2013 640639841 2014-09-10 JACKSON CARDIOLOGY ASSOCIATES, P.A. 30
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2002-01-01
Business code 621111
Sponsor’s telephone number 6019818543
Plan sponsor’s address 971 LAKELAND DRIVE, STE. 850, JACKSON, MS, 39216

Signature of
Role Plan administrator
Date 2014-09-10
Name of individual signing TELLIS ELLIS
Valid signature Filed with authorized/valid electronic signature
JACKSON CARDIOLOGY ASSOCIATES, P.A. PROFIT SHARIN 401(K) PLAN 2012 640639841 2013-08-06 JACKSON CARDIOLOGY ASSOCIATES, P.A. 28
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2002-01-01
Business code 621111
Sponsor’s telephone number 6019818543
Plan sponsor’s address 971 LAKELAND DRIVE, STE. 850, JACKSON, MS, 39216

Signature of
Role Plan administrator
Date 2013-08-06
Name of individual signing TELLIS ELLIS
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2013-08-06
Name of individual signing TELLIS ELLIS
Valid signature Filed with authorized/valid electronic signature
JACKSON CARDIOLOGY ASSOCIATES, P.A. PROFIT SHARIN 401(K) PLAN 2011 640639841 2012-07-12 JACKSON CARDIOLOGY ASSOCIATES, P.A. 28
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2002-01-01
Business code 621111
Sponsor’s telephone number 6019818543
Plan sponsor’s address 971 LAKELAND DRIVE, STE. 850, JACKSON, MS, 39216

Plan administrator’s name and address
Administrator’s EIN 640639841
Plan administrator’s name JACKSON CARDIOLOGY ASSOCIATES, P.A.
Plan administrator’s address 971 LAKELAND DRIVE, STE. 850, JACKSON, MS, 39216
Administrator’s telephone number 6019818543

Signature of
Role Plan administrator
Date 2012-07-12
Name of individual signing TELLIS ELLIS
Valid signature Filed with authorized/valid electronic signature
JACKSON CARDIOLOGY ASSOCIATES, P.A. PROFIT SHARIN 401(K) PLAN 2010 640639841 2011-06-28 JACKSON CARDIOLOGY ASSOCIATES, P.A. 29
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2002-01-01
Business code 621111
Sponsor’s telephone number 6019818543
Plan sponsor’s address 971 LAKELAND DRIVE, STE. 850, JACKSON, MS, 39216

Plan administrator’s name and address
Administrator’s EIN 640639841
Plan administrator’s name JACKSON CARDIOLOGY ASSOCIATES, P.A.
Plan administrator’s address 971 LAKELAND DRIVE, STE. 850, JACKSON, MS, 39216
Administrator’s telephone number 6019818543

Signature of
Role Plan administrator
Date 2011-06-28
Name of individual signing TELLIS B. ELLIS, III, M.D.
Valid signature Filed with authorized/valid electronic signature
JACKSON CARDIOLOGY ASSOCIATES, P.A. PROFIT SHARIN 401(K) PLAN 2009 640639841 2010-09-23 JACKSON CARDIOLOGY ASSOCIATES, P.A. 27
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2002-01-01
Business code 621111
Sponsor’s telephone number 6019818543
Plan sponsor’s address 971 LAKELAND DRIVE, STE. 850, JACKSON, MS, 39216

Plan administrator’s name and address
Administrator’s EIN 640639841
Plan administrator’s name JACKSON CARDIOLOGY ASSOCIATES, P.A.
Plan administrator’s address 971 LAKELAND DRIVE, STE. 850, JACKSON, MS, 39216
Administrator’s telephone number 6019818543

Signature of
Role Plan administrator
Date 2010-09-23
Name of individual signing TELLIS B. ELLIS, III, M.D.
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
TELLIS B ELLIS III Agent 971 LAKELAND DR #850, JACKSON, MS 39216

Director

Name Role Address
Malcolm P Taylor Director 6501 Dogwood View Parkway, Suite C, Jackson, MS 39213
Richard Rayford Director 6501 Dogwood VIew Parkway, Suite C, Jackson, MS 39213

President

Name Role Address
Malcolm P Taylor President 6501 Dogwood View Parkway, Suite C, Jackson, MS 39213

Secretary

Name Role Address
Malcolm P Taylor Secretary 6501 Dogwood View Parkway, Suite C, Jackson, MS 39213

Assistant Secretary

Name Role Address
Richard Rayford Assistant Secretary 6501 Dogwood VIew Parkway, Suite C, Jackson, MS 39213

Vice President

Name Role Address
Richard Rayford Vice President 6501 Dogwood VIew Parkway, Suite C, Jackson, MS 39213

Filings

Type Status Filed Date Description
Admin Dissolution Filed 2019-11-22 Admin Dissolution: AR
Notice to Dissolve/Revoke Filed 2019-08-22 Notice to Dissolve/Revoke
Annual Report Filed 2018-04-15 Annual Report For JACKSON CARDIOLOGY ASSOCIATES, P. A.
Annual Report Filed 2017-04-10 Annual Report For JACKSON CARDIOLOGY ASSOCIATES, P. A.
Annual Report Filed 2016-04-13 Annual Report For JACKSON CARDIOLOGY ASSOCIATES, P. A.
Annual Report Filed 2015-03-25 Annual Report For JACKSON CARDIOLOGY ASSOCIATES, P. A.
Annual Report Filed 2014-03-21 Annual Report
Annual Report Filed 2013-03-07 Annual Report
Annual Report Filed 2012-04-02 Annual Report
Annual Report Filed 2011-03-22 Annual Report

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Related by address

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Date of last update: 10 Dec 2024

Sources: Mississippi Secretary of State

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