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  5. PRENTISS PRIMARY CARE, P.A.

PRENTISS PRIMARY CARE, P.A.

Company Details

Name: PRENTISS PRIMARY CARE, P.A.
Jurisdiction: MISSISSIPPI
Business Type: Profit Corporation
Status: Good Standing
Effective Date: 22 Oct 2002 (22 years ago)
Business ID: 724284
ZIP code: 39474
County: Jefferson Davis
State of Incorporation: MISSISSIPPI
Principal Office Address: 1529 Columbia AvenuePrentiss, MS 39474
Historical names: Madison Primary Care DBA

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
PRENTISS PRIMARY CARE, P.A. 401K PROFIT SHARING PLAN 2023 061656535 2024-10-01 PRENTISS PRIMARY CARE, P.A. 9
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2005-01-01
Business code 621111
Sponsor’s telephone number 6017923200
Plan sponsor’s address 610 BERRIDGE DRIVE, RIDGELAND, MS, 39157

Signature of
Role Plan administrator
Date 2024-10-01
Name of individual signing JAISHANKAR JAGADEESAN
Valid signature Filed with authorized/valid electronic signature
PRENTISS PRIMARY CARE, P.A. 401K PROFIT SHARING PLAN 2022 061656535 2023-10-16 PRENTISS PRIMARY CARE, P.A. 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2005-01-01
Business code 621111
Sponsor’s telephone number 6017923200
Plan sponsor’s address 610 BERRIDGE DRIVE, RIDGELAND, MS, 39157

Signature of
Role Plan administrator
Date 2023-10-16
Name of individual signing JAISHANKAR JAGADEESAN
Valid signature Filed with authorized/valid electronic signature
PRENTISS PRIMARY CARE, P.A. 401K PROFIT SHARING PLAN 2021 061656535 2022-10-14 PRENTISS PRIMARY CARE, P.A. 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2005-01-01
Business code 621111
Sponsor’s telephone number 6017923200
Plan sponsor’s address 610 BERRIDGE DRIVE, RIDGELAND, MS, 39157

Signature of
Role Plan administrator
Date 2022-10-14
Name of individual signing JAISHANKAR JAGADEESAN
Valid signature Filed with authorized/valid electronic signature
PRENTISS PRIMARY CARE, P.A. 401K PROFIT SHARING PLAN 2020 061656535 2021-12-29 PRENTISS PRIMARY CARE, P.A. 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2005-01-01
Business code 621111
Sponsor’s telephone number 6017923200
Plan sponsor’s address 610 BERRIDGE DRIVE, RIDGELAND, MS, 39157

Signature of
Role Plan administrator
Date 2021-12-29
Name of individual signing JAISHANKAR JAGADEESAN
Valid signature Filed with authorized/valid electronic signature
PRENTISS PRIMARY CARE, P.A. 401K PROFIT SHARING PLAN 2019 061656535 2020-10-10 PRENTISS PRIMARY CARE, P.A. 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2005-01-01
Business code 621111
Sponsor’s telephone number 6017923200
Plan sponsor’s address 610 BERRIDGE DRIVE, RIDGELAND, MS, 39157

Signature of
Role Plan administrator
Date 2020-10-10
Name of individual signing JAISHANKAR JAGADEESAN
Valid signature Filed with authorized/valid electronic signature
PRENTISS PRIMARY CARE, P.A. 401K PROFIT SHARING PLAN 2018 061656535 2019-10-14 PRENTISS PRIMARY CARE, P.A. 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2005-01-01
Business code 621111
Sponsor’s telephone number 6017923200
Plan sponsor’s address 610 BERRIDGE DRIVE, RIDGELAND, MS, 39157

Signature of
Role Plan administrator
Date 2019-10-14
Name of individual signing JAISHANKAR JAGADEESAN
Valid signature Filed with authorized/valid electronic signature
PRENTISS PRIMARY CARE, PA 401(K) PROFIT SHARING PLAN 2017 061656535 2018-06-03 PRENTISS PRIMARY CARE, P.A. 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2005-01-01
Business code 621111
Sponsor’s telephone number 6017923200
Plan sponsor’s address 1150 BERRY STREET, PRENTISS, MS, 39474

Signature of
Role Plan administrator
Date 2018-06-03
Name of individual signing JAISHANKAR JAGADEESAN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2018-06-03
Name of individual signing JAISHANKAR JAGADEESAN
Valid signature Filed with authorized/valid electronic signature
PRENTISS PRIMARY CARE, PA 401(K) PROFIT SHARING PLAN 2016 061656535 2017-07-15 PRENTISS PRIMARY CARE, P.A. 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2005-01-01
Business code 621111
Sponsor’s telephone number 6017923200
Plan sponsor’s address 1150 BERRY STREET, PRENTISS, MS, 39474

Signature of
Role Plan administrator
Date 2017-07-15
Name of individual signing JAISHANKAR JAGADEESAN
Valid signature Filed with authorized/valid electronic signature
PRENTISS PRIMARY CARE, PA 401(K) PROFIT SHARING PLAN 2015 061656535 2016-07-06 PRENTISS PRIMARY CARE, P.A. 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2005-01-01
Business code 621111
Sponsor’s telephone number 6017923200
Plan sponsor’s address 972 COLUMBIA AVENUE, PRENTISS, MS, 39474

Signature of
Role Plan administrator
Date 2016-07-06
Name of individual signing JAISHANKAR JAGADEESAN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2016-07-06
Name of individual signing JAISHANKAR JAGADEESAN
Valid signature Filed with authorized/valid electronic signature
PRENTISS PRIMARY CARE, P.A. 401K PROFIT SHARING PLAN 2012 061656535 2013-07-21 PRENTISS PRIMARY CARE, P.A. 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2005-01-01
Business code 621111
Sponsor’s telephone number 6017923200
Plan sponsor’s address 610 BERRIDGE DRIVE, RIDGELAND, MS, 39157

Plan administrator’s name and address
Administrator’s EIN 061656535
Plan administrator’s name PRENTISS PRIMARY CARE, P.A.
Plan administrator’s address 610 BERRIDGE DRIVE, RIDGELAND, MS, 39157
Administrator’s telephone number 6017923200

Signature of
Role Plan administrator
Date 2013-07-21
Name of individual signing JAISHANKAR JAGADEESAN
Valid signature Filed with authorized/valid electronic signature
Three-digit plan number (PN) 001
Effective date of plan 2005-01-01
Business code 621111
Sponsor’s telephone number 6017923200
Plan sponsor’s address 610 BERRIDGE DRIVE, RIDGELAND, MS, 39157

Plan administrator’s name and address
Administrator’s EIN 061656535
Plan administrator’s name PRENTISS PRIMARY CARE, P.A.
Plan administrator’s address 610 BERRIDGE DRIVE, RIDGELAND, MS, 39157
Administrator’s telephone number 6017923200

Signature of
Role Plan administrator
Date 2013-07-21
Name of individual signing JAISHANKAR JAGADEESAN
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2012/10/13/20121013203926P040001654678001.pdf
Three-digit plan number (PN) 001
Effective date of plan 2005-01-01
Business code 621111
Sponsor’s telephone number 6017923200
Plan sponsor’s address 610 BERRIDGE DRIVE, RIDGELAND, MS, 39157

Plan administrator’s name and address
Administrator’s EIN 061656535
Plan administrator’s name PRENTISS PRIMARY CARE, P.A.
Plan administrator’s address 610 BERRIDGE DRIVE, RIDGELAND, MS, 39157
Administrator’s telephone number 6017923200

Signature of
Role Plan administrator
Date 2012-10-13
Name of individual signing JAISHANKAR JAGADEESAN
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2011/04/04/20110404142839P040171047712001.pdf
Three-digit plan number (PN) 001
Effective date of plan 2005-01-01
Business code 621111
Sponsor’s telephone number 6017923200
Plan sponsor’s address 610 BERRIDGE DRIVE, RIDGELAND, MS, 39157

Plan administrator’s name and address
Administrator’s EIN 061656535
Plan administrator’s name PRENTISS PRIMARY CARE, P.A.
Plan administrator’s address 610 BERRIDGE DRIVE, RIDGELAND, MS, 39157
Administrator’s telephone number 6017923200

Signature of
Role Plan administrator
Date 2011-04-04
Name of individual signing JAISHANKAR JAGADEESAN
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2010/07/29/20100729174737P040031873271001.pdf
Three-digit plan number (PN) 001
Effective date of plan 2005-01-01
Business code 621111
Sponsor’s telephone number 6017923200
Plan sponsor’s mailing address 610 BERRIDGE DRIVE, RIDGELAND, MS, 39157
Plan sponsor’s address 610 BERRIDGE DRIVE, RIDGELAND, MS, 39157

Plan administrator’s name and address
Administrator’s EIN 061656535
Plan administrator’s name PRENTISS PRIMARY CARE, P.A.
Plan administrator’s address 610 BERRIDGE DRIVE, RIDGELAND, MS, 39157
Administrator’s telephone number 6017923200

Number of participants as of the end of the plan year
Active participants 4
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 0
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 0
Number of participants with account balances as of the end of the plan year 4
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 0

Signature of
Role Plan administrator
Date 2010-07-29
Name of individual signing JAISHANKAR JAGADEESAN
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
JAISHANKAR JAGADEESAN Agent 610 Berridge Drive, Ridgeland, MS 39157

Incorporator

Name Role Address
Jaishankar Jagadeesan Incorporator 610 Bearidge Drive, Ridgeland, MS 39157

Director

Name Role Address
Jaishankar Jagadeesan Director 1529 Columbia Ave, P.o. Box 1373, Prentiss, MS 39474

President

Name Role Address
Jaishankar Jagadeesan President 1529 Columbia Ave, P.o. Box 1373, Prentiss, MS 39474

Filings

Type Status Filed Date Description
Annual Report Filed 2024-05-15 Annual Report For PRENTISS PRIMARY CARE, P.A.
Annual Report Filed 2023-04-23 Annual Report For PRENTISS PRIMARY CARE, P.A.
Annual Report Filed 2022-04-14 Annual Report For PRENTISS PRIMARY CARE, P.A.
Annual Report Filed 2021-04-18 Annual Report For PRENTISS PRIMARY CARE, P.A.
Annual Report Filed 2020-05-20 Annual Report For PRENTISS PRIMARY CARE, P.A.
Annual Report Filed 2019-04-10 Annual Report For PRENTISS PRIMARY CARE, P.A.
Annual Report Filed 2018-03-29 Annual Report For PRENTISS PRIMARY CARE, P.A.
Annual Report Filed 2017-04-08 Annual Report For PRENTISS PRIMARY CARE, P.A.
Annual Report Filed 2016-04-10 Annual Report For PRENTISS PRIMARY CARE, P.A.
Annual Report Filed 2015-03-31 Annual Report For PRENTISS PRIMARY CARE, P.A.

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Related by address

No related companies by address

Date of last update: 28 Dec 2024

Sources: Mississippi Secretary of State

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