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  5. Sartell Pediatrics, P.A.

Sartell Pediatrics, P.A.

Company Details

Name: Sartell Pediatrics, P.A.
Jurisdiction: Minnesota
Legal type: Business Corporation (Domestic)
Status: Active / In Good Standing
Date formed: 26 Jan 2012 (13 years ago)
Company Number: 11856cfc-b94d-e111-8159-001ec94ffe7f
File Number: 467069000020
Registered Office Address: 111 2nd St So, Sartell, MN 56377, USA
Principal Executive Office Address: 111 2nd Str S, Sartell, MN 56377, USA
ZIP code: 56377
County: Stearns County
Place of Formation: Minnesota

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
SARTELL PEDIATRICS, P.A. 401(K) PLAN 2023 454376781 2024-07-23 SARTELL PEDIATRICS, P.A. 51
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2017-01-01
Business code 621111
Sponsor’s telephone number 3202813339
Plan sponsor’s address 111 SECOND STREET SOUTH, SARTELL, MN, 56377

Signature of
Role Plan administrator
Date 2024-07-22
Name of individual signing JILL SMITH
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2024-07-22
Name of individual signing JILL SMITH
Valid signature Filed with authorized/valid electronic signature
SARTELL PEDIATRICS, P.A. 401(K) PLAN 2022 454376781 2023-05-15 SARTELL PEDIATRICS, P.A. 53
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2017-01-01
Business code 621111
Sponsor’s telephone number 3202813339
Plan sponsor’s address 111 SECOND STREET SOUTH, SARTELL, MN, 56377

Signature of
Role Plan administrator
Date 2023-05-15
Name of individual signing JILL SMITH
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2023-05-15
Name of individual signing JILL SMITH
Valid signature Filed with authorized/valid electronic signature
SARTELL PEDIATRICS 401(K) PLAN 2021 454376781 2022-03-08 SARTELL PEDIATRICS, P.A. 34
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2017-01-01
Business code 621111
Sponsor’s telephone number 3202813339
Plan sponsor’s address 111 SECOND STREET SOUTH, SARTELL, MN, 56377

Signature of
Role Plan administrator
Date 2022-03-07
Name of individual signing JILL SMITH
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2022-03-07
Name of individual signing JILL SMITH
Valid signature Filed with authorized/valid electronic signature
SARTELL PEDIATRICS 401(K) PLAN 2020 454376781 2021-03-08 SARTELL PEDIATRICS, P.A. 23
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2017-01-01
Business code 621111
Sponsor’s telephone number 3202813339
Plan sponsor’s address 111 SECOND STREET SOUTH, SARTELL, MN, 56377

Signature of
Role Plan administrator
Date 2021-03-08
Name of individual signing JILL SMITH
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2021-03-08
Name of individual signing JILL SMITH
Valid signature Filed with authorized/valid electronic signature
SARTELL PEDIATRICS 401(K) PLAN 2019 464376781 2020-06-08 SARTELL PEDIATRICS, P.A. 22
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2017-01-01
Business code 621111
Sponsor’s telephone number 3202813339
Plan sponsor’s address 111 SECOND STREET SOUTH, SARTELL, MN, 56377

Signature of
Role Plan administrator
Date 2020-06-05
Name of individual signing JILL SMITH
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2020-06-05
Name of individual signing JILL SMITH
Valid signature Filed with authorized/valid electronic signature
SARTELL PEDIATRICS 401(K) PLAN 2019 454376781 2021-02-09 SARTELL PEDIATRICS, P.A. 22
Three-digit plan number (PN) 001
Effective date of plan 2017-01-01
Business code 621111
Sponsor’s telephone number 3202813339
Plan sponsor’s address 111 SECOND STREET SOUTH, SARTELL, MN, 56377

Signature of
Role Plan administrator
Date 2021-02-09
Name of individual signing JILL SMITH
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2021-02-09
Name of individual signing JILL SMITH
Valid signature Filed with authorized/valid electronic signature
SARTELL PEDIATRICS 401(K) PLAN 2019 454376781 2022-09-08 SARTELL PEDIATRICS, P.A. 22
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2017-01-01
Business code 621111
Sponsor’s telephone number 3202813339
Plan sponsor’s address 111 SECOND STREET SOUTH, SARTELL, MN, 56377

Signature of
Role Plan administrator
Date 2022-09-08
Name of individual signing JILL SMITH
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2022-09-08
Name of individual signing JILL SMITH
Valid signature Filed with authorized/valid electronic signature
SARTELL PEDIATRICS 401(K) PLAN 2018 454376781 2019-07-29 SARTELL PEDIATRICS, P.A. 20
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2017-01-01
Business code 621111
Sponsor’s telephone number 3202813339
Plan sponsor’s address 111 SECOND STREET SOUTH, SARTELL, MN, 56377

Signature of
Role Plan administrator
Date 2019-07-29
Name of individual signing JILL SMITH
Valid signature Filed with authorized/valid electronic signature
SARTELL PEDIATRICS 401(K) PLAN 2017 454376781 2018-07-11 SARTELL PEDIATRICS, P.A. 16
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2017-01-01
Business code 621111
Sponsor’s telephone number 3202813339
Plan sponsor’s address 111 SECOND STREET SOUTH, SARTELL, MN, 56377

Signature of
Role Plan administrator
Date 2018-07-11
Name of individual signing JILL SMITH
Valid signature Filed with authorized/valid electronic signature

Chief Executive Officer

Name Role Address
David Smith Chief Executive Officer 111 2nd Str S, Sartell, MN 56377, USA

Agent

Name Role
David L Smith Agent

Filing

Filing Name Filing date
Amendment - Business Corporation (Domestic) (Business Name: Sartell Pediatrics, P.A.)Change of Shares Professional Service - Medicine & Surgery 2012-08-22
Registered Office and/or Agent - Business Corporation (Domestic) 2012-08-13
Original Filing - Business Corporation (Domestic) (Business Name: Sartell Pediatrics Inc) 2012-01-26

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Related by address

111 2nd Str S, Sartell, MN 56377, USA

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Date of last update: 27 Sep 2024

Sources: Minnesota's Official State Website

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