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  5. STARKVILLE PEDIATRIC CLINIC, LLC

STARKVILLE PEDIATRIC CLINIC, LLC

Company Details

Name: STARKVILLE PEDIATRIC CLINIC, LLC
Jurisdiction: MISSISSIPPI
Business Type: Limited Liability Company
Status: Merged
Effective Date: 03 Dec 2001 (23 years ago)
Business ID: 709913
ZIP code: 39759
County: Oktibbeha
State of Incorporation: MISSISSIPPI
Principal Office Address: #5 PROFESSIONAL PLAZASTARKVILLE, MS 39759

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
STARKVILLE PEDIATRIC CLINIC 401(K) PLAN 2023 640947032 2024-08-26 STARKVILLE PEDIATRIC CLINIC 20
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621111
Sponsor’s telephone number 6623230999
Plan sponsor’s address 5 PROFESSIONAL PLZ., STARKVILLE, MS, 39759

Signature of
Role Plan administrator
Date 2024-08-26
Name of individual signing CYNTHIA RUFF
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2024-08-26
Name of individual signing CYNTHIA RUFF
Valid signature Filed with authorized/valid electronic signature
STARKVILLE PEDIATRIC CLINIC 401(K) PLAN 2022 640947032 2023-06-27 STARKVILLE PEDIATRIC CLINIC 19
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621111
Sponsor’s telephone number 6623230999
Plan sponsor’s address 5 PROFESSIONAL PLZ., STARKVILLE, MS, 39759

Signature of
Role Plan administrator
Date 2023-06-27
Name of individual signing DR. ROBERT CAIN
Valid signature Filed with authorized/valid electronic signature
STARKVILLE PEDIATRIC CLINIC 401(K) PLAN 2021 640947032 2022-07-20 STARKVILLE PEDIATRIC CLINIC 22
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621111
Sponsor’s telephone number 6623230999
Plan sponsor’s address 5 PROFESSIONAL PLZ., STARKVILLE, MS, 39759

Signature of
Role Plan administrator
Date 2022-07-20
Name of individual signing DR. ROBERT CAIN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2022-07-20
Name of individual signing PAIGE SIMMONS
Valid signature Filed with authorized/valid electronic signature
STARKVILLE PEDIATRIC CLINIC 401(K) PLAN 2020 640947032 2021-09-21 STARKVILLE PEDIATRIC CLINIC 20
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621111
Sponsor’s telephone number 6623230999
Plan sponsor’s address 5 PROFESSIONAL PLZ., STARKVILLE, MS, 39759

Signature of
Role Plan administrator
Date 2021-09-21
Name of individual signing DR. DEBORAH SHIRLEY
Valid signature Filed with authorized/valid electronic signature
STARKVILLE PEDIATRIC CLINIC 401(K) PLAN 2019 640947032 2020-07-10 STARKVILLE PEDIATRIC CLINIC 18
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621111
Sponsor’s telephone number 6623230999
Plan sponsor’s address 5 PROFESSIONAL PLZ., STARKVILLE, MS, 39759

Signature of
Role Plan administrator
Date 2020-07-10
Name of individual signing DR. DEBORAH SHIRLEY
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2020-07-10
Name of individual signing DR. DEBORAH SHIRLEY
Valid signature Filed with authorized/valid electronic signature
STARKVILLE PEDIATRIC CLINIC 401(K) PLAN 2018 640947032 2019-04-22 STARKVILLE PEDIATRIC CLINIC 18
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621111
Sponsor’s telephone number 6623230999
Plan sponsor’s address 5 PROFESSIONAL PLZ., STARKVILLE, MS, 39759

Signature of
Role Plan administrator
Date 2019-04-22
Name of individual signing DR. DEBORAH SHIRLEY
Valid signature Filed with authorized/valid electronic signature
STARKVILLE PEDIATRIC CLINIC 401(K) PLAN 2017 640947032 2018-05-31 STARKVILLE PEDIATRIC CLINIC 17
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621111
Sponsor’s telephone number 6623230999
Plan sponsor’s address 5 PROFESSIONAL PLZ, STARKVILLE, MS, 39759

Signature of
Role Plan administrator
Date 2018-05-31
Name of individual signing DR. DEBORAH SHIRLEY
Valid signature Filed with authorized/valid electronic signature
STARKVILLE PEDIATRIC CLINIC 401(K) PLAN 2016 640947032 2017-05-30 STARKVILLE PEDIATRIC CLINIC 18
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621111
Sponsor’s telephone number 6623230999
Plan sponsor’s address 5 PROFESSIONAL PLZ, STARKVILLE, MS, 39759

Signature of
Role Plan administrator
Date 2017-05-30
Name of individual signing DEBORAH A SHIRLEY
Valid signature Filed with authorized/valid electronic signature
STARKVILLE PEDIATRIC CLINIC 401(K) PLAN 2015 640947032 2016-07-12 STARKVILLE PEDIATRIC CLINIC 19
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621111
Sponsor’s telephone number 6623230999
Plan sponsor’s address #5 PROFESSIONAL PLAZA, STARKVILLE, MS, 39759

Signature of
Role Plan administrator
Date 2016-07-12
Name of individual signing DEBORAH A SHIRLEY
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
DEBORAH A SHIRLEY Agent 102 DOCTORS PARK, STARKVILLE, MS 39759

Member

Name Role Address
DEBORAH A SHIRLEY Member 102 PRESSLY DR, STARKVILLE, MS 39759

Manager

Name Role Address
Deborah A Shirley Manager 102 PRESSLY DR, STARKVILLE, MS 39759

Filings

Type Status Filed Date Description
Merger Filed 2014-04-04 Merger
Annual Report LLC Filed 2014-03-09 Annual Report LLC
Annual Report LLC Filed 2013-02-23 Annual Report LLC
Annual Report LLC Filed 2012-02-25 Annual Report LLC
Amendment Form Filed 2003-03-19 Amendment

Related by officers

No related officers

Related by address

#5 PROFESSIONAL PLAZASTARKVILLE, MS 39759

STARKVILLE PEDIATRIC CLINIC, PLLC

Date of last update: 27 Dec 2024

Sources: Mississippi Secretary of State

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