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  5. Orthopaedic Institute of North Mississippi, PLLC

Orthopaedic Institute of North Mississippi, PLLC

Company Details

Name: Orthopaedic Institute of North Mississippi, PLLC
Jurisdiction: MISSISSIPPI
Business Type: Limited Liability Company
Status: Good Standing
Effective Date: 22 Apr 2002 (23 years ago)
Business ID: 869177
ZIP code: 38801
County: Lee
State of Incorporation: MISSISSIPPI
Principal Office Address: 499 Gloster Creek Village, Suite G-1Tupelo, MS 38801
Historical names: Orthopedic Institute of North Mississippi, PLLC
North Mississippi Sports Medicine & Orthopaedic Clinic, PLLC

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
ORTHOPAEDIC INSTITUTE OF NORTH MISSISSIPPI, PLLC RETIREMENT PLAN AND TRUST 2021 470866603 2022-02-14 ORTHOPAEDIC INSTITUTE OF NORTH MISSISSIPPI, PLLC 44
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621111
Sponsor’s telephone number 6623772663
Plan sponsor’s address 499 GLOSTER CREEK VILLAGE, STE G1, TUPELO, MS, 38801

Signature of
Role Plan administrator
Date 2022-02-14
Name of individual signing CAROL FARRIS-UPTON
Valid signature Filed with authorized/valid electronic signature
ORTHOPAEDIC INSTITUTE OF NORTH MISSISSIPPI, PLLC PENSION PLAN 2021 470866603 2022-09-23 ORTHOPAEDIC INSTITUTE OF NORTH MISSISSIPPI 37
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2004-01-01
Business code 621111
Sponsor’s telephone number 6628405747
Plan sponsor’s address 499 GLOSTER CREEK VILLAGE, STE G1, TUPELO, MS, 38801

Signature of
Role Plan administrator
Date 2022-09-23
Name of individual signing CAROL UPTON
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2022-09-23
Name of individual signing CAROL UPTON
Valid signature Filed with authorized/valid electronic signature
ORTHOPAEDIC INSTITUTE OF NORTH MISSISSIPPI, PLLC PENSION PLAN 2021 470866603 2022-09-23 ORTHOPAEDIC INSTITUTE OF NORTH MISSISSIPPI 31
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2004-01-01
Business code 621111
Sponsor’s telephone number 6628405747
Plan sponsor’s address 499 GLOSTER CREEK VILLAGE, STE G1, TUPELO, MS, 38801

Signature of
Role Plan administrator
Date 2022-09-23
Name of individual signing CAROL UPTON
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2022-09-23
Name of individual signing CAROL UPTON
Valid signature Filed with authorized/valid electronic signature
ORTHOPAEDIC INSTITUTE OF NORTH MISSISSIPPI, PLLC PENSION PLAN 2020 470866603 2021-07-27 ORTHOPAEDIC INSTITUTE OF NORTH MISSISSIPPI 37
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2004-01-01
Business code 621111
Sponsor’s telephone number 6628405747
Plan sponsor’s address 499 GLOSTER CREEK VILLAGE, STE G1, TUPELO, MS, 38801

Signature of
Role Plan administrator
Date 2021-07-27
Name of individual signing CAROL UPTON
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2021-07-27
Name of individual signing CAROL UPTON
Valid signature Filed with authorized/valid electronic signature
ORTHOPAEDIC INSTITUTE OF NORTH MISSISSIPPI, PLLC RETIREMENT PLAN AND TRUST 2020 470866603 2021-08-12 ORTHOPAEDIC INSTITUTE OF NORTH MISSISSIPPI, PLLC 40
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621111
Sponsor’s telephone number 6623772663
Plan sponsor’s address 499 GLOSTER CREEK VILLAGE, STE G1, TUPELO, MS, 38801

Signature of
Role Plan administrator
Date 2021-08-12
Name of individual signing CAROL FARRIS-UPTON
Valid signature Filed with authorized/valid electronic signature
ORTHOPAEDIC INSTITUTE OF NORTH MISSISSIPPI, PLLC PENSION PLAN 2019 470866603 2020-09-16 ORTHOPAEDIC INSTITUTE OF NORTH MISSISSIPPI 34
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2004-01-01
Business code 621111
Sponsor’s telephone number 6628405747
Plan sponsor’s address 499 GLOSTER CREEK VILLAGE, STE G1, TUPELO, MS, 38801
ORTHOPAEDIC INSTITUTE OF NORTH MISSISSIPPI, PLLC RETIREMENT PLAN AND TRUST 2019 470866603 2020-07-21 ORTHOPAEDIC INSTITUTE OF NORTH MISSISSIPPI, PLLC 35
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621111
Sponsor’s telephone number 6623772663
Plan sponsor’s address 499 GLOSTER CREEK VILLAGE, STE G1, TUPELO, MS, 38801

Signature of
Role Plan administrator
Date 2020-07-21
Name of individual signing CAROL FARRIS-UPTON
Valid signature Filed with authorized/valid electronic signature
COLLINS ADVANCED DERMATOLOGY INSTITUTE 401(K) PLAN 2019 461872434 2020-09-04 ORTHOPAEDIC INSTITUTE OF NORTH MISSISSIPPI, PLLC 17
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-01-01
Business code 621111
Sponsor’s telephone number 6623772663
Plan sponsor’s address 499 GLOSTER CREEK VILLAGE, STE G1, TUPELO, MS, 38801

Signature of
Role Plan administrator
Date 2020-09-04
Name of individual signing CHRISTOPHER D. COLLINS
Valid signature Filed with authorized/valid electronic signature
ORTHOPAEDIC INSTITUTE OF NORTH MISSISSIPPI, PLLC RETIREMENT PLAN AND TRUST 2018 470866603 2019-07-12 ORTHOPAEDIC INSTITUTE OF NORTH MISSISSIPPI, PLLC 23
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621111
Sponsor’s telephone number 6623772663
Plan sponsor’s address 499 GLOSTER CREEK VILLAGE, STE G1, TUPELO, MS, 38801

Signature of
Role Plan administrator
Date 2019-07-12
Name of individual signing GINGER BRYANT
Valid signature Filed with authorized/valid electronic signature
COLLINS ADVANCED DERMATOLOGY INSTITUTE 401(K) PLAN 2018 461872434 2020-09-04 ORTHOPAEDIC INSTITUTE OF NORTH MISSISSIPPI, PLLC 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-01-01
Business code 621111
Sponsor’s telephone number 6623772663
Plan sponsor’s address 499 GLOSTER CREEK VILLAGE, STE G1, TUPELO, MS, 38801

Signature of
Role Plan administrator
Date 2020-09-04
Name of individual signing CHRISTOPHER D. COLLINS
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2019/06/19/20190619124459P040109885199001.pdf
Three-digit plan number (PN) 002
Effective date of plan 2004-01-01
Business code 621111
Sponsor’s telephone number 6628405747
Plan sponsor’s address 499 GLOSTER CREEK VILLAGE, STE G1, TUPELO, MS, 38801

Signature of
Role Plan administrator
Date 2019-06-19
Name of individual signing STEPHEN SOUTHWORTH
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2019-06-19
Name of individual signing STEPHEN SOUTHWORTH
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2017/05/01/20170501155222P040009246477001.pdf
Three-digit plan number (PN) 002
Effective date of plan 2004-01-01
Business code 621111
Sponsor’s telephone number 6628405747
Plan sponsor’s address 4381 S. EASON BOULEVARD, SUITE 303, TUPELO, MS, 388016585

Signature of
Role Plan administrator
Date 2017-05-01
Name of individual signing GINGER BRYANT
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2017-05-01
Name of individual signing GINGER BRYANT
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2016/05/05/20160505150421P040064897425001.pdf
Three-digit plan number (PN) 002
Effective date of plan 2004-01-01
Business code 621111
Sponsor’s telephone number 6628405747
Plan sponsor’s address 4381 S. EASON BOULEVARD, SUITE 303, TUPELO, MS, 388016585

Signature of
Role Plan administrator
Date 2016-05-03
Name of individual signing STEPHEN SOUTHWORTH
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2016-05-03
Name of individual signing STEPHEN SOUTHWORTH
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2015/04/29/20150429144946P040198053287001.pdf
Three-digit plan number (PN) 002
Effective date of plan 2004-01-01
Business code 621111
Sponsor’s telephone number 6628405747
Plan sponsor’s address 4381 S. EASON BOULEVARD, SUITE 303, TUPELO, MS, 388016585

Signature of
Role Plan administrator
Date 2015-04-29
Name of individual signing STEPHEN SOUTHWORTH
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2015-04-29
Name of individual signing STEPHEN SOUTHWORTH
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2014/05/19/20140519153128P040352720915001.pdf
Three-digit plan number (PN) 002
Effective date of plan 2004-01-01
Business code 621111
Sponsor’s telephone number 6628405747
Plan sponsor’s address 4381 S. EASON BOULEVARD, SUITE 303, TUPELO, MS, 388016585

Signature of
Role Plan administrator
Date 2014-05-19
Name of individual signing STEPHEN SOUTHWORTH
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2014-05-19
Name of individual signing STEPHEN SOUTHWORTH
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2013/05/10/20130510144303P040011731632001.pdf
Three-digit plan number (PN) 002
Effective date of plan 2004-01-01
Business code 621111
Sponsor’s telephone number 6628405747
Plan sponsor’s address 4381 S. EASON BOULEVARD, SUITE 303, TUPELO, MS, 388016585

Signature of
Role Plan administrator
Date 2013-05-10
Name of individual signing NELS THORDERSON
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2013-05-10
Name of individual signing NELS THORDERSON
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2012/05/07/20120507124115P040009118866001.pdf
Three-digit plan number (PN) 002
Effective date of plan 2004-01-01
Business code 621111
Sponsor’s telephone number 6628405747
Plan sponsor’s address 4381 S. EASON BOULEVARD, SUITE 303, TUPELO, MS, 388016585

Plan administrator’s name and address
Administrator’s EIN 470866603
Plan administrator’s name NORTH MISSISSIPPI SPORTS MEDICINE & ORTHOPAEDIC CLINIC, PLLC
Plan administrator’s address 4381 S. EASON BOULEVARD, SUITE 303, TUPELO, MS, 388016585
Administrator’s telephone number 6628405747

Signature of
Role Plan administrator
Date 2012-05-07
Name of individual signing GINGER WESTON
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2012-05-07
Name of individual signing GINGER WESTON
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2011/05/05/20110505095805P040054875601001.pdf
Three-digit plan number (PN) 002
Effective date of plan 2004-01-01
Business code 621111
Sponsor’s telephone number 6628405747
Plan sponsor’s address 4381 S. EASON BOULEVARD, SUITE 303, TUPELO, MS, 388016585

Plan administrator’s name and address
Administrator’s EIN 470866603
Plan administrator’s name NORTH MISSISSIPPI SPORTS MEDICINE & ORTHOPAEDIC CLINIC, PLLC
Plan administrator’s address 4381 S. EASON BOULEVARD, SUITE 303, TUPELO, MS, 388016585
Administrator’s telephone number 6628405747

Signature of
Role Plan administrator
Date 2011-05-05
Name of individual signing STEPHEN SOUTHWORTH, MD
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2011-05-05
Name of individual signing STEPHEN SOUTHWORTH, MD
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2010/08/13/20100813145658P030146940450001.pdf
Three-digit plan number (PN) 002
Effective date of plan 2004-01-01
Business code 621111
Sponsor’s telephone number 6628405747
Plan sponsor’s address 4381 S. EASON BOULEVARD, SUITE 303, TUPELO, MS, 388016585

Plan administrator’s name and address
Administrator’s EIN 470866603
Plan administrator’s name NORTH MISSISSIPPI SPORTS MEDICINE & ORTHOPAEDIC CLINIC, PLLC
Plan administrator’s address 4381 S. EASON BOULEVARD, SUITE 303, TUPELO, MS, 388016585
Administrator’s telephone number 6628405747

Signature of
Role Plan administrator
Date 2010-08-12
Name of individual signing STEPHEN SOUTHWORTH, MD
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2010-08-12
Name of individual signing STEPHEN SOUTHWORTH, MD
Valid signature Filed with authorized/valid electronic signature
Three-digit plan number (PN) 002
Effective date of plan 2004-01-01
Business code 621111
Sponsor’s telephone number 6628405747
Plan sponsor’s address 4381 S. EASON BOULEVARD, SUITE 202, TUPELO, MS, 388016585

Plan administrator’s name and address
Administrator’s EIN 470866603
Plan administrator’s name NORTH MISSISSIPPI SPORTS MEDICINE & ORTHOPAEDIC CLINIC, PLLC
Plan administrator’s address 4381 S. EASON BOULEVARD, SUITE 202, TUPELO, MS, 388016585
Administrator’s telephone number 6628405747

Signature of
Role Plan administrator
Date 2010-08-09
Name of individual signing STEPHEN SOUTHWORTH, MD
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2010-08-09
Name of individual signing STEPHEN SOUTHWORTH, MD
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
Delgadillo, Albert G Agent 105 South Front Street;P O Box 7120, Tupelo, MS 38802

Member

Name Role Address
Eric V Lewis Member 499 Gloster Creek Village, Suite G-1, Tupelo, MS 38801
Albert G Delgadillo Member 105 South Front Street, PO Box 7120, Tupelo, MS 38802

Filings

Type Status Filed Date Description
Annual Report LLC Filed 2024-04-26 Annual Report For Orthopaedic Institute of North Mississippi, PLLC
Annual Report LLC Filed 2023-02-14 Annual Report For Orthopaedic Institute of North Mississippi, PLLC
Annual Report LLC Filed 2022-03-24 Annual Report For Orthopaedic Institute of North Mississippi, PLLC
Amendment Form Filed 2021-06-28 Amendment For Orthopaedic Institute of North Mississippi, PLLC
Annual Report LLC Filed 2021-03-12 Annual Report For Orthopaedic Institute of North Mississippi, PLLC
Annual Report LLC Filed 2020-03-25 Annual Report For Orthopaedic Institute of North Mississippi, PLLC
Annual Report LLC Filed 2019-04-11 Annual Report For Orthopaedic Institute of North Mississippi, PLLC
Amendment Form Filed 2018-08-13 Amendment For Orthopedic Institute of North Mississippi, PLLC
Amendment Form Filed 2018-08-01 Amendment For North Mississippi Sports Medicine & Orthopaedic Clinic, PLLC
Annual Report LLC Filed 2018-03-07 Annual Report For North Mississippi Sports Medicine & Orthopaedic Clinic, PLLC

Related by officers

Delgadillo, Albert G

THE ASTRO-LOUNGER MANUFACTURING COMPANY, INC. DAVIS FURNITURE INDUSTRIES, INC. HOULKA TRUCKING, INC. SILVER DOLLAR SALES, INC. MISSISSIPPI NATIONAL FURNITURE MART, INC. NICHOLS SAW SERVICE, INC. MISSISSIPPI NATIONAL MART OF HIGH POINT, INC. REX PLAZA SUITES, INC. D C, INC. ADAMS FARMS, INC.

Eric V Lewis

Eric V. Lewis, M.D., PLLC OINM Holdco, LLC OINM Incentive Holdco, LLC

Albert G Delgadillo

THE SCHAPER CO. SANDERS CLINIC FOR WOMEN, P.A. MICHAEL A. TODD, M.D., P.A. TOMMY BROOKS OIL COMPANY MATTHEWS REALTY CORPORATION ENTERPRISES III, INC. SUPERIOR SALES, INCORPORATED WEBB'S FLYING SERVICE, INC. KM & M, INC. KEYSTONE CAPITAL MANAGEMENT, INC.

Related by address

499 Gloster Creek Village, Suite G-1Tupelo, MS 38801

Nels W. Thorderson, M.D., PLLC Gabriel J Rulewicz M.D. PLLC William P. Pillow, M.D., PLLC Bryan C. Fagan, M.D., PLLC OINM Holdco, LLC OINM Incentive Holdco, LLC

Date of last update: 09 Jan 2025

Sources: Mississippi Secretary of State

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