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  5. North Mississippi Primary Health Care, Inc.

North Mississippi Primary Health Care, Inc.

Company Details

Name: North Mississippi Primary Health Care, Inc.
Jurisdiction: MISSISSIPPI
Business Type: Non Profit Corporation
Status: Good Standing
Effective Date: 17 Jan 1984 (41 years ago)
Business ID: 513919
ZIP code: 38603
County: Benton
State of Incorporation: MISSISSIPPI
Principal Office Address: 15921 Boundary Drive, PO Box 92Ashland, MS 38603
Historical names: NORTH BENTON COUNTY HEALTH CARE, INC.

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
NORTH MISSISSIPPI PRIMARY HEALTH CARE INC 401(K) PLAN 2023 640686443 2024-10-14 NORTH MISSISSIPPI PRIMARY HEALTH CARE INC. 109
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1998-08-01
Business code 621111
Sponsor’s telephone number 6625023153
Plan sponsor’s address 15921 WEST BOUNDARY DR, ASHLAND, MS, 38603

Signature of
Role Plan administrator
Date 2024-10-14
Name of individual signing ROB JETER
Valid signature Filed with authorized/valid electronic signature
NORTH MISSISSIPPI PRIMARY HEALTH CARE, INC 401(K) PLAN 2022 640686443 2023-05-23 NORTH MISSISSIPPI PRIMARY HEALTH CARE INC. 96
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1998-08-01
Business code 621111
Sponsor’s telephone number 6622248951
Plan sponsor’s address 15921 WEST BOUNDARY DR, ASHLAND, MS, 38603

Signature of
Role Plan administrator
Date 2023-05-23
Name of individual signing TAMMY G CHAPMAN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2023-05-23
Name of individual signing TAMMY G CHAPMAN
Valid signature Filed with authorized/valid electronic signature
NORTH MISSISSIPPI PRIMARY HEALTH CARE, INC 401(K) PLAN 2021 640686443 2022-05-09 NORTH MISSISSIPPI PRIMARY HEALTH CARE INC. 96
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1998-08-01
Business code 621111
Sponsor’s telephone number 6622248951
Plan sponsor’s address 15921 WEST BOUNDARY DR, ASHLAND, MS, 38603

Signature of
Role Plan administrator
Date 2022-05-09
Name of individual signing TAMMY G CHAPMAN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2022-05-09
Name of individual signing TAMMY G CHAPMAN
Valid signature Filed with authorized/valid electronic signature
NORTH MISSISSIPPI PRIMARY HEALTH CARE, INC 401(K) PLAN 2020 640686443 2021-05-04 NORTH MISSISSIPPI PRIMARY HEALTH CARE INC. 85
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1998-08-01
Business code 621111
Sponsor’s telephone number 6622248951
Plan sponsor’s address 15921 WEST BOUNDARY DR, ASHLAND, MS, 38603

Signature of
Role Plan administrator
Date 2021-05-04
Name of individual signing TAMMY CHAPMAN
Valid signature Filed with authorized/valid electronic signature
NORTH MISSISSIPPI PRIMARY HEALTH CARE, INC 401(K) PLAN 2019 640686443 2020-04-27 NORTH MISSISSIPPI PRIMARY HEALTH CARE INC. 80
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1998-08-01
Business code 621111
Sponsor’s telephone number 6622248951
Plan sponsor’s address 15921 WEST BOUNDARY DR, ASHLAND, MS, 38603

Signature of
Role Plan administrator
Date 2020-04-27
Name of individual signing TAMMY CHAPMAN
Valid signature Filed with authorized/valid electronic signature
NORTH MISSISSIPPI PRIMARY HEALTH CARE, INC 401(K) PLAN 2018 640686443 2019-05-13 NORTH MISSISSIPPI PRIMARY HEALTH CARE INC. 73
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1998-08-01
Business code 621111
Sponsor’s telephone number 6622248951
Plan sponsor’s address 15921 WEST BOUNDARY DR, ASHLAND, MS, 38603

Signature of
Role Plan administrator
Date 2019-05-13
Name of individual signing TAMMY G CHAPMAN
Valid signature Filed with authorized/valid electronic signature
NORTH MISSISSIPPI PRIMARY HEALTH CARE, INC 401(K) PLAN 2017 640686443 2018-05-08 NORTH MISSISSIPPI PRIMARY HEALTH CARE INC. 71
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1998-08-01
Business code 621111
Sponsor’s telephone number 6622248951
Plan sponsor’s address 15921 WEST BOUNDARY DR, ASHLAND, MS, 38603

Signature of
Role Plan administrator
Date 2018-05-08
Name of individual signing JAMES D NUNNALLY
Valid signature Filed with authorized/valid electronic signature
NORTH MISSISSIPPI PRIMARY HEALTH CARE, INC 401(K) PLAN 2016 640686443 2017-05-19 NORTH MISSISSIPPI PRIMARY HEALTH CARE INC 66
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1998-08-01
Business code 621111
Sponsor’s telephone number 6622248951
Plan sponsor’s address 15921 WEST BOUNDARY DR, ASHLAND, MS, 38603

Signature of
Role Plan administrator
Date 2017-05-19
Name of individual signing JAMES D NUNNALLY
Valid signature Filed with authorized/valid electronic signature
NORTH MISSISSIPPI PRIMARY HEALTH CARE, INC 401(K) PLAN 2015 640686443 2016-05-26 NORTH MISSISSIPPI PRIMARY HEALTH CARE INC 64
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1998-08-01
Business code 621111
Sponsor’s telephone number 6622248951
Plan sponsor’s address PO BOX 92, 15921 BOUNDARY DR, ASHLAND, MS, 38603

Signature of
Role Plan administrator
Date 2016-05-26
Name of individual signing TAMMY G CHAPMAN
Valid signature Filed with authorized/valid electronic signature
NORTH MISSISSIPPI PRIMARY HEALTH CARE, INC 401(K) PLAN 2014 640686443 2015-05-26 NORTH MISSISSIPPI PRIMARY HEALTH CARE, INC 64
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1998-08-01
Business code 621111
Sponsor’s telephone number 6622248951
Plan sponsor’s address 15921 BOUNDARY DR, PO BOX 92, ASHLAND, MS, 38603

Signature of
Role Plan administrator
Date 2015-05-26
Name of individual signing TAMMY G. CHAPMAN
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2014/05/21/20140521110807P030349435923001.pdf
Three-digit plan number (PN) 001
Effective date of plan 1998-08-01
Business code 621111
Sponsor’s telephone number 6622248951
Plan sponsor’s address 15921 WEST BOUNDARY DR, PO BOX 92, ASHLAND, MS, 38603

Signature of
Role Plan administrator
Date 2014-05-21
Name of individual signing TAMMY G CHAPMAN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2014-05-21
Name of individual signing TAMMY G CHAPMAN
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2013/05/13/20130513164331P030073862645001.pdf
Three-digit plan number (PN) 001
Effective date of plan 1998-08-01
Business code 621111
Sponsor’s telephone number 6622248951
Plan sponsor’s address 15921 BOUNDARY DRIVE, PO BOX 92, ASHLAND, MS, 38603

Signature of
Role Plan administrator
Date 2013-05-13
Name of individual signing JAMES D. NUNNALLY
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2012/05/08/20120508124110P030010024482001.pdf
Three-digit plan number (PN) 001
Effective date of plan 1998-08-01
Business code 621111
Sponsor’s telephone number 6622248951
Plan sponsor’s address 15921 WEST BOUNDARY DR, ASHLAND, MS, 38603

Plan administrator’s name and address
Administrator’s EIN 640686443
Plan administrator’s name NORTH MISSISSIPPI PRIMARY HEALTH CARE, INC
Plan administrator’s address 15921 WEST BOUNDARY DR, ASHLAND, MS, 38603
Administrator’s telephone number 6622248951

Signature of
Role Plan administrator
Date 2012-05-08
Name of individual signing JAMES D. NUNNALLY
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2011/04/18/20110418093322P040007754902001.pdf
Three-digit plan number (PN) 001
Effective date of plan 1998-08-01
Business code 621111
Sponsor’s telephone number 6622248951
Plan sponsor’s address 15921 BOUNDARY DRIVE, PO BOX 92, ASHLAND, MS, 38603

Plan administrator’s name and address
Administrator’s EIN 640686443
Plan administrator’s name NORTH MISSISSIPPI PRIMARY HEALTH CARE, INC
Plan administrator’s address 15921 BOUNDARY DRIVE, PO BOX 92, ASHLAND, MS, 38603
Administrator’s telephone number 6622248951

Signature of
Role Plan administrator
Date 2011-04-18
Name of individual signing TAMMY CHAPMAN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2011-04-18
Name of individual signing TAMMY G. CHAPMAN
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2010/06/03/20100603205350P030014046388001.pdf
Three-digit plan number (PN) 001
Effective date of plan 1998-08-01
Business code 621111
Sponsor’s telephone number 6622248951
Plan sponsor’s address 15921 WEST BOUNDARY DR, ASHLAND, MS, 38603

Plan administrator’s name and address
Administrator’s EIN 640686443
Plan administrator’s name NORTH MISSISSIPPI PRIMARY HEALTH CARE, INC
Plan administrator’s address 15921 WEST BOUNDARY DR, ASHLAND, MS, 38603
Administrator’s telephone number 6622248951

Signature of
Role Plan administrator
Date 2010-06-03
Name of individual signing TAMMY G. CHAPMAN
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
Bill Stone Agent 61 East St, Ashland, MS 38603

Chief Executive Officer

Name Role Address
Bill Stone Chief Executive Officer PO Box 92, Ashland, MS 38603

Director

Name Role Address
Steve Bostick Director PO Box 92, Ashland, MS 38603
Anthony L Farese Director PO Box 92, Ashland, MS 38603
Willie Ruth Daugherty Director PO Box 92, Ashland, MS 38603
Mary Carolyn Tucker Director PO Box 92, Ashland, MS 38603
Lewis Davis Director PO Box 92, Ashland, MS 38603
Gary Dunnam Director PO Box 92, Ashland, MS 38603
Bonnie Martindale Director PO Box 92, Ashland, MS 38603
Shelley Akins Director PO Box 92, Ashland, MS 38603
Tim Watson Director PO Box 92, Ashland, MS 38603
Jackie McKenzie Director PO Box 92, Ashland, MS 38603

Filings

Type Status Filed Date Description
Non-Profit Annual Report Filed 2025-02-17 Annual Report For North Mississippi Primary Health Care, Inc.
Registered Agent Change of Address Filed 2024-09-30 Agent Address Change For Bill Stone
Non-Profit Status Report Filed 2023-07-30 Status Report For North Mississippi Primary Health Care, Inc.
Non-Profit Status Report Filed 2023-07-25 Status Report For North Mississippi Primary Health Care, Inc.
Non-Profit Status Report Filed 2023-01-18 Status Report For North Mississippi Primary Health Care, Inc.
Amendment Form Filed 2009-06-11 Amendment
Amendment Form Filed 1989-06-23 Amendment
Amendment Form Filed 1985-01-22 Amendment
See File Filed 1985-01-22 See File
Name Reservation Form Filed 1984-01-17 Name Reservation

Tax Exempt

EIN Type of Organization Exempt Organization Status Address Ruling Date
64-0686443 Corporation Unconditional Exemption 15921 BOUNDARY DR, ASHLAND, MS, 38603-7740 1985-02
In Care of Name -
Group Exemption Number 0000
Subsection Charitable Organization, Educational Organization, Literary Organization, Organization to Prevent Cruelty to Animals, Organization to Prevent Cruelty to Children, Organization for Public Safety Testing, Religious Organization, Scientific Organization
Affiliation Independent - This code is used if the organization is an independent organization or an independent auxiliary (i.e., not affiliated with a National, Regional, or Geographic grouping of organizations).
Classification Government Instrumentality, Title-Holding Corporation, Charitable Organization, Agricultural Organization, Board of Trade, Pleasure, Recreational, or Social Club, Fraternal Beneficiary Society, Order or Association, Voluntary Employees' Beneficiary Association (Non-Govt. Emps.), Domestic Fraternal Societies and Associations, Teachers Retirement Fund Assoc., Benevolent Life Insurance Assoc., Burial Association, Credit Union, Mutual Insurance Company or Assoc. Other Than Life or Marine, Corp. Financing Crop Operations, Supplemental Unemployment Compensation Trust or Plan, Employee Funded Pension Trust (Created Before 6/25/59), Post or Organization of War Veterans, Legal Service Organization, Black Lung Trust, Multiemployer Pension Plan, Veterans Assoc. Formed Prior to 1880, Trust Described in Sect. 4049 of ERISA, Title Holding Co. for Pensions, etc., State-Sponsored High Risk Health Insurance Organizations, State-Sponsored Workers' Compensation Reinsurance, ACA 1322 Qualified Nonprofit Health Insurance Issuers, Apostolic and Religious Org. (501(d)), Cooperative Hospital Service Organization (501(e)), Cooperative Service Organization of Operating Educational Organization (501(f)), Child Care Organization (501(k)), Charitable Risk Pool, Qualified State-Sponsored Tuition Program, 4947(a)(1) - Private Foundation (Form 990PF Filer)
Deductibility Contributions are deductible.
Foundation Organization that receives a substantial part of its support from a governmental unit or the general public 170(b)(1)(A)(vi)
Tax Period 2023-03
Asset 50,000,000 to greater
Income 50,000,000 to greater
Filing Requirement 990 (all other) or 990EZ return
PF Filing Requirement No 990-PF return
Accounting Period Mar
Asset Amount 60093535
Income Amount 53652183
Form 990 Revenue Amount 53638958
National Taxonomy of Exempt Entities -
Sort Name -

Publication 78 Data
Description Organizations eligible to receive tax-deductible charitable contributions. Users may rely on this list in determining deductibility of their contributions.
On Publication 78 Data List Yes
Deductibility Type of organization and use of contribution: A public charity. Deductibility Limitation: 50% (60% for cash contributions)

Copies of Returns (990, 990-EZ, 990-PF, 990-T)
Organization Name NORTH MISSISSIPPI PRIMARY HEALTH CARE INC
EIN 64-0686443
Tax Period 202203
Filing Type E
Return Type 990
File View File
Organization Name NORTH MISSISSIPPI PRIMARY HEALTH CARE INC
EIN 64-0686443
Tax Period 202003
Filing Type E
Return Type 990
File View File
Organization Name NORTH MISSISSIPPI PRIMARY HEALTH CARE INC
EIN 64-0686443
Tax Period 201903
Filing Type E
Return Type 990
File View File
Organization Name NORTH MISSISSIPPI PRIMARY HEALTH CARE INC
EIN 64-0686443
Tax Period 201803
Filing Type E
Return Type 990
File View File
Organization Name NORTH MISSISSIPPI PRIMARY HEALTH CARE INC
EIN 64-0686443
Tax Period 201703
Filing Type E
Return Type 990
File View File
Organization Name NORTH MISSISSIPPI PRIMARY HEALTH CARE INC
EIN 64-0686443
Tax Period 201603
Filing Type E
Return Type 990
File View File

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Related by address

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Date of last update: 20 Apr 2025

Sources: Mississippi Secretary of State

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