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  5. AQUIDNECK PODIATRY LTD.

AQUIDNECK PODIATRY LTD.

Company Details

Name: AQUIDNECK PODIATRY LTD.
Jurisdiction: Rhode Island
Entity type: Professional Service Corporation
Status: Dissolved
Date of Organization in Rhode Island: 14 Jan 1982 (43 years ago)
Date of Dissolution: 18 Feb 2021 (4 years ago)
Date of Status Change: 18 Feb 2021 (4 years ago)
Identification Number: 000001225
ZIP code: 02840
County: Newport County
Principal Address: 55 MEMORIAL BOULEVARD, NEWPORT, RI, 02840, USA
Purpose: FOOT AND ANKLE MEDICAL CARE
NAICS: 621391 - Offices of Podiatrists
Historical names: AQUIDNECK PODIATRY GROUP, INC.

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1164636890 2007-05-10 2008-02-08 55 MEMORIAL BOULEVARD, SUITE 7, NEWPORT, RI, 028403679, US 55 MEMORIAL BOULEVARD, SUITE 7, NEWPORT, RI, 028403679, US

Contacts
Phone +1 401-846-2800
Fax 4018494899

Authorized person
Name DR. BRIAN WILLIAM CORNELL
Role PRESIDENT AQUIDNECK PODIATRY LTD
Phone 4018462800

Taxonomy
Taxonomy Code 213E00000X - Podiatrist
License Number DPM 00195
State RI
Is Primary Yes

Other Provider Identifiers
Issuer UNITED HEALTH
Number 2700178
State RI
Issuer BCBS
Number 71215
State RI
Issuer MEDICAID
Number 9007121
State RI

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
AQUIDNECK PODIATRY, LTD. 401(K) PROFIT SHARING PLAN 2021 050395275 2022-04-13 AQUIDNECK PODIATRY, LTD. 2
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1987-01-01
Business code 621391
Sponsor’s telephone number 4018462800
Plan sponsor’s address 55 MEMORAL BLVD., NEWPORT, RI, 02840
AQUIDNECK PODIATRY, LTD. 401(K) PROFIT SHARING PLAN 2020 050395275 2021-05-21 AQUIDNECK PODIATRY, LTD. 2
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1987-01-01
Business code 621391
Sponsor’s telephone number 4018462800
Plan sponsor’s address 55 MEMORAL BLVD., NEWPORT, RI, 02840
AQUIDNECK PODIATRY, LTD. 401(K) PROFIT SHARING PLAN 2019 050395275 2020-05-15 AQUIDNECK PODIATRY, LTD. 2
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1987-01-01
Business code 621391
Sponsor’s telephone number 4018462800
Plan sponsor’s address 55 MEMORAL BLVD., NEWPORT, RI, 02840
AQUIDNECK PODIATRY, LTD. 401(K) PROFIT SHARING PLAN 2018 050395275 2019-05-28 AQUIDNECK PODIATRY, LTD. 2
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1987-01-01
Business code 621391
Sponsor’s telephone number 4018462800
Plan sponsor’s address 55 MEMORAL BLVD., NEWPORT, RI, 02840
AQUIDNECK PODIATRY, LTD. 401(K) PROFIT SHARING PLAN 2017 050395275 2018-04-23 AQUIDNECK PODIATRY, LTD. 2
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1987-01-01
Business code 621391
Sponsor’s telephone number 4018462800
Plan sponsor’s address 55 MEMORAL BLVD., NEWPORT, RI, 02840
AQUIDNECK PODIATRY, LTD. 401(K) PROFIT SHARING PLAN 2016 050395275 2017-06-09 AQUIDNECK PODIATRY, LTD. 2
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1987-01-01
Business code 621391
Sponsor’s telephone number 4018462800
Plan sponsor’s address 55 MEMORAL BLVD., NEWPORT, RI, 02840
AQUIDNECK PODIATRY, LTD. 401(K) PROFIT SHARING PLAN 2015 050395275 2016-02-29 AQUIDNECK PODIATRY, LTD. 2
Three-digit plan number (PN) 002
Effective date of plan 1987-01-01
Business code 621391
Sponsor’s telephone number 4018462800
Plan sponsor’s address 55 MEMORIAL BLVD., NEWPORT, RI, 02840

Plan administrator’s name and address
Administrator’s EIN 050395275
Plan administrator’s name AQUIDNECK PODIATRY, LTD.
Plan administrator’s address 55 MEMORIAL BLVD., NEWPORT, RI, 02840
Administrator’s telephone number 4018462800

Signature of
Role Plan administrator
Date 2016-02-29
Name of individual signing BRIAN CORNELL
Valid signature Filed with authorized/valid electronic signature
AQUIDNECK PODIATRY, LTD. 401(K) PROFIT SHARING PLAN 2015 050395275 2016-05-11 AQUIDNECK PODIATRY, LTD. 2
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1987-01-01
Business code 621391
Sponsor’s telephone number 4018462800
Plan sponsor’s address 55 MEMORIAL BLVD., NEWPORT, RI, 02840

Plan administrator’s name and address
Administrator’s EIN 050395275
Plan administrator’s name AQUIDNECK PODIATRY, LTD.
Plan administrator’s address 55 MEMORIAL BLVD., NEWPORT, RI, 02840
Administrator’s telephone number 4018462800

Signature of
Role Plan administrator
Date 2016-05-11
Name of individual signing BRIAN CORNELL
Valid signature Filed with authorized/valid electronic signature
AQUIDNECK PODIATRY, LTD. 401(K) PROFIT SHARING PLAN 2014 050395275 2015-03-31 AQUIDNECK PODIATRY, LTD. 2
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1987-01-01
Business code 621391
Sponsor’s telephone number 4018462800
Plan sponsor’s address 55 MEMORIAL BLVD., NEWPORT, RI, 02840

Plan administrator’s name and address
Administrator’s EIN 050395275
Plan administrator’s name AQUIDNECK PODIATRY, LTD.
Plan administrator’s address 55 MEMORIAL BLVD., NEWPORT, RI, 02840
Administrator’s telephone number 4018462800

Signature of
Role Plan administrator
Date 2015-03-31
Name of individual signing BRIAN CORNELL
Valid signature Filed with authorized/valid electronic signature
AQUIDNECK PODIATRY, LTD. 401(K) PROFIT SHARING PLAN 2013 050395275 2014-03-19 AQUIDNECK PODIATRY, LTD. 2
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1987-01-01
Business code 621391
Sponsor’s telephone number 4018462800
Plan sponsor’s address 55 MEMORIAL BLVD., NEWPORT, RI, 02840

Plan administrator’s name and address
Administrator’s EIN 050395275
Plan administrator’s name AQUIDNECK PODIATRY, LTD.
Plan administrator’s address 55 MEMORIAL BLVD., NEWPORT, RI, 02840
Administrator’s telephone number 4018462800

Signature of
Role Plan administrator
Date 2014-03-19
Name of individual signing BRIAN CORNELL
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2013/07/17/20130717135040P040391289729001.pdf
Three-digit plan number (PN) 002
Effective date of plan 1987-01-01
Business code 621391
Sponsor’s telephone number 4018462800
Plan sponsor’s address 55 MEMORIAL BLVD., NEWPORT, RI, 02840

Plan administrator’s name and address
Administrator’s EIN 050395275
Plan administrator’s name AQUIDNECK PODIATRY, LTD.
Plan administrator’s address 55 MEMORIAL BLVD., NEWPORT, RI, 02840
Administrator’s telephone number 4018462800

Signature of
Role Plan administrator
Date 2013-07-17
Name of individual signing BRIAN CORNELL
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2012/04/18/20120418141751P040070473233001.pdf
Three-digit plan number (PN) 002
Effective date of plan 1987-01-01
Business code 621391
Sponsor’s telephone number 4018462800
Plan sponsor’s address 55 MEMORIAL BLVD., NEWPORT, RI, 02840

Plan administrator’s name and address
Administrator’s EIN 050395275
Plan administrator’s name AQUIDNECK PODIATRY, LTD.
Plan administrator’s address 55 MEMORIAL BLVD., NEWPORT, RI, 02840
Administrator’s telephone number 4018462800

Signature of
Role Plan administrator
Date 2012-04-18
Name of individual signing BRIAN W. CORNELL
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2011/02/23/20110223131740P030014820945001.pdf
Three-digit plan number (PN) 002
Effective date of plan 1987-01-01
Business code 621391
Sponsor’s telephone number 4018462800
Plan sponsor’s address 55 MEMORIAL BLVD., NEWPORT, RI, 02840

Plan administrator’s name and address
Administrator’s EIN 050395275
Plan administrator’s name AQUIDNECK PODIATRY, LTD.
Plan administrator’s address 55 MEMORIAL BLVD., NEWPORT, RI, 02840
Administrator’s telephone number 4018462800

Signature of
Role Plan administrator
Date 2011-02-23
Name of individual signing BRIAN W. CORNELL
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2010/06/24/20100624213247P030012795733001.pdf
Three-digit plan number (PN) 002
Effective date of plan 1987-01-01
Business code 621391
Sponsor’s telephone number 4018462800
Plan sponsor’s address 55 MEMORIAL BLVD., NEWPORT, RI, 02840

Plan administrator’s name and address
Administrator’s EIN 050395275
Plan administrator’s name AQUIDNECK PODIATRY, LTD.
Plan administrator’s address 55 MEMORIAL BLVD., NEWPORT, RI, 02840
Administrator’s telephone number 4018462800

Signature of
Role Plan administrator
Date 2010-06-23
Name of individual signing BRIAN W. CORNELL
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
BRIAN CORNELL Agent 55 MEMORIAL BOULEVARD, NEWPORT, RI, 02840, USA

PRESIDENT

Name Role Address
BRIAN W CORNELL PRESIDENT 55 MEMORIAL BOULEVARD NEWPORT, RI 02840 USA

Events

Type Date Old Value New Value
Name Change 1985-04-29 AQUIDNECK PODIATRY GROUP, INC. AQUIDNECK PODIATRY LTD.

Filings

Number Name File Date
202191937350 Articles of Dissolution 2021-02-18
202033698230 Annual Report 2020-02-03
201986115300 Annual Report 2019-02-06
201857894240 Annual Report 2018-02-08
201733711610 Annual Report 2017-02-06
201691016710 Annual Report 2016-01-19
201554580680 Annual Report 2015-02-04
201435060340 Annual Report 2014-02-04
201312291050 Annual Report 2013-02-20
201289306090 Annual Report 2012-02-09

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Related by address

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Date of last update: 05 Oct 2024

Sources: Rhode Island Department of State

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