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  5. BILOXI INTERNAL MEDICINE CLINIC, P.A.

BILOXI INTERNAL MEDICINE CLINIC, P.A.

Company Details

Name: BILOXI INTERNAL MEDICINE CLINIC, P.A.
Jurisdiction: MISSISSIPPI
Business Type: Profit Corporation
Status: Good Standing
Effective Date: 19 Feb 1985 (40 years ago)
Business ID: 522006
ZIP code: 39530
County: Harrison
State of Incorporation: MISSISSIPPI
Principal Office Address: 147 Reynoir St, Suite 101Biloxi, MS 39530

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
BILOXI INTERNAL MEDICINE P.A. 401(K) SALARY SAVINGS PLAN 2023 640706496 2024-05-03 BILOXI INTERNAL MEDICINE CLINIC P.A 19
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1985-03-01
Business code 621111
Sponsor’s telephone number 2283742051
Plan sponsor’s address 147 REYNOIR STREET, SUITE 101, BILOXI, MS, 39530

Signature of
Role Plan administrator
Date 2024-05-03
Name of individual signing BENNETT W. CHENEY
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2024-05-03
Name of individual signing BENNETT W. CHENEY
Valid signature Filed with authorized/valid electronic signature
BILOXI INTERNAL MEDICINE P.A. 401(K) SALARY SAVINGS PLAN 2022 640706496 2023-05-23 BILOXI INTERNAL MEDICINE CLINIC P.A. 19
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1985-03-01
Business code 621111
Sponsor’s telephone number 2283742051
Plan sponsor’s address 147 REYNOIR STREET, SUITE 101, BILOXI, MS, 39530

Signature of
Role Plan administrator
Date 2023-05-23
Name of individual signing BEN CHENEY
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2023-05-23
Name of individual signing BEN CHENEY
Valid signature Filed with authorized/valid electronic signature
BILOXI INTERNAL MEDICINE P.A. 401(K) SALARY SAVINGS PLAN 2021 640706496 2022-05-20 BILOXI INTERNAL MEDICINE CLINIC P.A. 20
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1985-03-01
Business code 621111
Sponsor’s telephone number 2283742051
Plan sponsor’s address 147 REYNOIR STREET, SUITE 101, BILOXI, MS, 39530

Signature of
Role Plan administrator
Date 2022-05-20
Name of individual signing BENNETT CHENEY
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2022-05-20
Name of individual signing BENNETT CHENEY
Valid signature Filed with authorized/valid electronic signature
BILOXI INTERNAL MEDICINE P.A. 401(K) SALARY SAVINGS PLAN 2020 640706496 2021-05-26 BILOXI INTERNAL MEDICINE CLINIC P.A. 20
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1985-03-01
Business code 621111
Sponsor’s telephone number 2283742051
Plan sponsor’s address 147 REYNOIR STREET, SUITE 101, BILOXI, MS, 39530

Signature of
Role Plan administrator
Date 2021-05-26
Name of individual signing BENNETT CHENEY
Valid signature Filed with authorized/valid electronic signature
BILOXI INTERNAL MEDICINE P.A. 401(K) SALARY SAVINGS PLAN 2019 640706496 2020-09-09 BILOXI INTERNAL MEDICINE CLINIC P.A. 18
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1985-03-01
Business code 621111
Sponsor’s telephone number 2283742051
Plan sponsor’s address 147 REYNOIR STREET, SUITE 101, BILOXI, MS, 39530

Signature of
Role Plan administrator
Date 2020-09-09
Name of individual signing JULIE GUTTIERREZ
Valid signature Filed with authorized/valid electronic signature
BILOXI INTERNAL MEDICINE CLINIC 401(K) PLAN 2018 640706496 2019-06-26 BILOXI INTERNAL MEDICINE CLINIC P.A. 18
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1985-03-01
Business code 621111
Sponsor’s telephone number 2283742051
Plan sponsor’s address 147 REYNOIR STREET, SUITE 101, BILOXI, MS, 39530

Signature of
Role Plan administrator
Date 2019-06-26
Name of individual signing BENNETT CHENEY
Valid signature Filed with authorized/valid electronic signature
BILOXI INTERNAL MEDICINE P.A. 401(K) SALARY SAVINGS PLAN 2018 640706496 2020-09-09 BILOXI INTERNAL MEDICINE CLINIC P.A. 18
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1985-03-01
Business code 621111
Sponsor’s telephone number 2283742051
Plan sponsor’s address 147 REYNOIR STREET, SUITE 101, BILOXI, MS, 39530

Signature of
Role Plan administrator
Date 2020-09-09
Name of individual signing BENNETT CHENEY
Valid signature Filed with authorized/valid electronic signature
BILOXI INTERNAL MEDICINE P.A. 401(K) SALARY SAVINGS PLAN 2018 640706496 2019-07-03 BILOXI INTERNAL MEDICINE CLINIC P.A. 18
Three-digit plan number (PN) 001
Effective date of plan 1985-03-01
Business code 621111
Sponsor’s telephone number 2283742051
Plan sponsor’s address 147 REYNOIR STREET, SUITE 101, BILOXI, MS, 39530

Signature of
Role Plan administrator
Date 2019-07-03
Name of individual signing BENNETT CHENEY
Valid signature Filed with authorized/valid electronic signature

Incorporator

Name Role Address
Marion Wainwright Incorporator 147 Reynoir St Ste 204, Biloxi, MS 39530

President

Name Role Address
Bennett W. Cheney MD President 147 Reynoir St, Ste 101, Biloxi, MS 39530

Director

Name Role Address
Gholam Reza Motakhaveri MD Director 147 Reynoir St, Ste 101, Biloxi, MS 39530
Yashashree L. Bethala MD Director 147 Reynoir St, Ste 101, Biloxi, MS 39530
Andrew J. Peterson Director 147 Reynoir St, Ste 101, Biloxi, MS 39530
Bennett W. Cheney MD Director 147 Reynoir St, Ste 101, Biloxi, MS 39530

Vice President

Name Role Address
Gholam Reza Motakhaveri MD Vice President 147 Reynoir St, Ste 101, Biloxi, MS 39530

Secretary

Name Role Address
Yashashree L. Bethala MD Secretary 147 Reynoir St, Ste 101, Biloxi, MS 39530

Treasurer

Name Role Address
Yashashree L. Bethala MD Treasurer 147 Reynoir St, Ste 101, Biloxi, MS 39530

Agent

Name Role Address
Bennett W. Cheney MD Agent 147 Reynoir St, Ste 101, Biloxi, MS 39530

Filings

Type Status Filed Date Description
Annual Report Filed 2024-04-03 Annual Report For BILOXI INTERNAL MEDICINE CLINIC, P.A.
Annual Report Filed 2023-03-28 Annual Report For BILOXI INTERNAL MEDICINE CLINIC, P.A.
Annual Report Filed 2022-03-22 Annual Report For BILOXI INTERNAL MEDICINE CLINIC, P.A.
Annual Report Filed 2021-07-20 Annual Report For BILOXI INTERNAL MEDICINE CLINIC, P.A.
Annual Report Filed 2020-04-15 Annual Report For BILOXI INTERNAL MEDICINE CLINIC, P.A.
Annual Report Filed 2019-09-03 Annual Report For BILOXI INTERNAL MEDICINE CLINIC, P.A.
Notice to Dissolve/Revoke Filed 2019-08-22 Notice to Dissolve/Revoke
Amendment Form Filed 2019-05-24 Amendment For BILOXI INTERNAL MEDICINE CLINIC, P.A.
Annual Report Filed 2018-03-21 Annual Report For BILOXI INTERNAL MEDICINE CLINIC, P.A.
Annual Report Filed 2017-01-16 Annual Report For BILOXI INTERNAL MEDICINE CLINIC, P.A.

Related by officers

No related officers

Related by address

No related companies by address

Date of last update: 20 Dec 2024

Sources: Mississippi Secretary of State

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