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  5. SOUTH COUNTY PEDIATRIC GROUP, INC.

SOUTH COUNTY PEDIATRIC GROUP, INC.

Company Details

Name: SOUTH COUNTY PEDIATRIC GROUP, INC.
Jurisdiction: Rhode Island
Entity type: Professional Service Corporation
Status: Dissolved
Date of Organization in Rhode Island: 01 Dec 1971 (53 years ago)
Date of Dissolution: 15 Nov 2023 (a year ago)
Date of Status Change: 15 Nov 2023 (a year ago)
Identification Number: 000012999
ZIP code: 02882
County: Washington County
Principal Address: 360 KINGSTON ROAD, NARRAGANSETT, RI, 02882, USA
Purpose: MEDICAL SERVICES
NAICS: 621111 - Offices of Physicians (except Mental Health Specialists)

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1417033986 2006-10-27 2009-10-01 4979 TOWER HILL RD, WAKEFIELD, RI, 028792283, US 4979 TOWER HILL RD, WAKEFIELD, RI, 028792283, US

Contacts
Phone +1 401-789-6492
Fax 4017895524

Authorized person
Name DAVID J. CHRONLEY
Role PRESIDENT
Phone 4017896492

Taxonomy
Taxonomy Code 208000000X - Pediatrics Physician
Is Primary Yes

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
SOUTH COUNTY PEDIATRIC GROUP, INC. PROFIT SHARING PLAN AND TRUST 2021 050346133 2022-11-17 SOUTH COUNTY PEDIATRIC GROUP, INC. 20
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1973-01-01
Business code 621111
Sponsor’s telephone number 4017896492
Plan sponsor’s address 360 KINGSTOWN ROAD, SUITE 101, NARRAGANSETT, RI, 02882
SOUTH COUNTY PEDIATRIC GROUP, INC. PROFIT SHARING PLAN AND TRUST 2021 050346133 2022-04-12 SOUTH COUNTY PEDIATRIC GROUP, INC. 16
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1973-01-01
Business code 621111
Sponsor’s telephone number 4017896492
Plan sponsor’s address 360 KINGSTOWN ROAD, SUITE 101, NARRAGANSETT, RI, 02882
SOUTH COUNTY PEDIATRIC GROUP, INC. PROFIT SHARING PLAN AND TRUST 2020 050346133 2021-03-05 SOUTH COUNTY PEDIATRIC GROUP, INC. 17
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1973-01-01
Business code 621111
Sponsor’s telephone number 4017896492
Plan sponsor’s address 360 KINGSTOWN ROAD, SUITE 101, NARRAGANSETT, RI, 02882

Signature of
Role Plan administrator
Date 2021-03-05
Name of individual signing PATRICIA MURPHY
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2021-03-05
Name of individual signing PATRICIA MURPHY
Valid signature Filed with authorized/valid electronic signature
SOUTH COUNTY PEDIATRIC GROUP, INC. PROFIT SHARING PLAN AND TRUST 2019 050346133 2020-07-15 SOUTH COUNTY PEDIATRIC GROUP, INC. 17
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1973-01-01
Business code 621111
Sponsor’s telephone number 4017896492
Plan sponsor’s address 360 KINGSTOWN ROAD, SUITE 101, NARRAGANSETT, RI, 02882

Signature of
Role Plan administrator
Date 2020-07-15
Name of individual signing PATRICIA MURPHY
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2020-07-15
Name of individual signing PATRICIA MURPHY
Valid signature Filed with authorized/valid electronic signature
SOUTH COUNTY PEDIATRIC GROUP, INC. PROFIT SHARING PLAN AND TRUST 2018 050346133 2019-07-08 SOUTH COUNTY PEDIATRIC GROUP, INC. 17
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1973-01-01
Business code 621111
Sponsor’s telephone number 4017896492
Plan sponsor’s address 360 KINGSTOWN ROAD, SUITE 101, NARRAGANSETT, RI, 02882

Signature of
Role Plan administrator
Date 2019-07-08
Name of individual signing DAVID CHRONLEY
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2019-07-08
Name of individual signing DAVID CHRONLEY
Valid signature Filed with authorized/valid electronic signature
SOUTH COUNTY PEDIATRIC GROUP, INC. PROFIT SHARING PLAN AND TRUST 2017 050346133 2018-08-16 SOUTH COUNTY PEDIATRIC GROUP, INC. 16
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1973-01-01
Business code 621111
Sponsor’s telephone number 4017896492
Plan sponsor’s address 360 KINGSTOWN ROAD, SUITE 101, NARRAGANSETT, RI, 02882

Signature of
Role Plan administrator
Date 2018-08-16
Name of individual signing PATRICIA MURPHY
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2018-08-16
Name of individual signing PATRICIA MURPHY
Valid signature Filed with authorized/valid electronic signature
SOUTH COUNTY PEDIATRIC GROUP, INC. PROFIT SHARING PLAN AND TRUST 2016 050346133 2017-09-07 SOUTH COUNTY PEDIATRIC GROUP, INC. 16
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1973-01-01
Business code 621111
Sponsor’s telephone number 4017896492
Plan sponsor’s address 360 KINGSTOWN ROAD, SUITE 101, NARRAGANSETT, RI, 02882

Signature of
Role Plan administrator
Date 2017-09-07
Name of individual signing PATRICIA MURPHY
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2017-09-07
Name of individual signing PATRICIA MURPHY
Valid signature Filed with authorized/valid electronic signature
SOUTH COUNTY PEDIATRIC GROUP, INC. PROFIT SHARING PLAN AND TRUST 2015 050346133 2016-09-13 SOUTH COUNTY PEDIATRIC GROUP, INC. 17
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1973-01-01
Business code 621111
Sponsor’s telephone number 4017896492
Plan sponsor’s address 4979 TOWER HILL ROAD, WAKEFIELD, RI, 02879

Signature of
Role Plan administrator
Date 2016-09-13
Name of individual signing DAVID CHRONLEY
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2016-09-13
Name of individual signing DAVID CHRONLEY
Valid signature Filed with authorized/valid electronic signature
SOUTH COUNTY PEDIATRIC GROUP, INC. PROFIT SHARING PLAN AND TRUST 2014 050346133 2015-10-09 SOUTH COUNTY PEDIATRIC GROUP, INC. 18
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1973-01-01
Business code 621111
Sponsor’s telephone number 4017896492
Plan sponsor’s address 4979 TOWER HILL ROAD, WAKEFIELD, RI, 02879

Signature of
Role Plan administrator
Date 2015-10-09
Name of individual signing DAVID CHRONLEY
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2015-10-09
Name of individual signing DAVID CHRONLEY
Valid signature Filed with authorized/valid electronic signature
SOUTH COUNTY PEDIATRIC GROUP, INC. PROFIT SHARING PLAN AND TRUST 2013 050346133 2014-10-07 SOUTH COUNTY PEDIATRIC GROUP, INC. 17
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1973-12-01
Business code 621111
Sponsor’s telephone number 4017896492
Plan sponsor’s address 4979 TOWER HILL ROAD, WAKEFIELD, RI, 02879

Signature of
Role Plan administrator
Date 2014-10-07
Name of individual signing DAVID CHRONLEY
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2014-10-07
Name of individual signing DAVID CHRONLEY
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2013/08/29/20130829131610P040470429041001.pdf
Three-digit plan number (PN) 001
Effective date of plan 1973-12-01
Business code 621111
Sponsor’s telephone number 4017896492
Plan sponsor’s address 4979 TOWER HILL ROAD, WAKEFIELD, RI, 02879

Signature of
Role Plan administrator
Date 2013-08-29
Name of individual signing DAVID CHRONLEY
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2013-08-29
Name of individual signing DAVID CHRONLEY
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2012/03/15/20120315163512P030233849168001.pdf
Three-digit plan number (PN) 001
Effective date of plan 1973-12-01
Business code 621111
Sponsor’s telephone number 4017896492
Plan sponsor’s address 4979 TOWER HILL ROAD, WAKEFIELD, RI, 02879

Plan administrator’s name and address
Administrator’s EIN 050346133
Plan administrator’s name SOUTH COUNTY PEDIATRIC GROUP, INC.
Plan administrator’s address 4979 TOWER HILL ROAD, WAKEFIELD, RI, 02879
Administrator’s telephone number 4017896492

Signature of
Role Plan administrator
Date 2012-03-15
Name of individual signing DAVID CHRONLEY
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2012-03-15
Name of individual signing DAVID CHRONLEY
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2011/02/07/20110207145808P040006340129001.pdf
Three-digit plan number (PN) 001
Effective date of plan 1973-12-01
Business code 621111
Sponsor’s telephone number 4017896492
Plan sponsor’s address 4979 TOWER HILL ROAD, WAKEFIELD, RI, 02879

Plan administrator’s name and address
Administrator’s EIN 050346133
Plan administrator’s name SOUTH COUNTY PEDIATRIC GROUP, INC.
Plan administrator’s address 4979 TOWER HILL ROAD, WAKEFIELD, RI, 02879
Administrator’s telephone number 4017896492

Signature of
Role Plan administrator
Date 2011-02-07
Name of individual signing DAVID CHRONLEY
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2011-02-07
Name of individual signing DAVID CHRONLEY
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2010/09/23/20100923131712P040000671062001.pdf
Three-digit plan number (PN) 001
Effective date of plan 1973-12-01
Business code 621111
Sponsor’s telephone number 4017896492
Plan sponsor’s address 4979 TOWER HILL ROAD, WAKEFIELD, RI, 02879

Plan administrator’s name and address
Administrator’s EIN 050346133
Plan administrator’s name SOUTH COUNTY PEDIATRIC GROUP, INC.
Plan administrator’s address 4979 TOWER HILL ROAD, WAKEFIELD, RI, 02879
Administrator’s telephone number 4017896492

Signature of
Role Plan administrator
Date 2010-09-23
Name of individual signing DAVID CHRONLEY
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2010-09-23
Name of individual signing DAVID CHRONLEY
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
JAMES S. LAWRENCE, ESQ. Agent 2374 POST ROAD, WARWICK, RI, 02886, USA

PRESIDENT

Name Role Address
DAVID J CHRONLEY MD PRESIDENT 360 KINGSTON ROAD NARRAGANSETT, RI 02882 USA

Filings

Number Name File Date
202342770490 Articles of Dissolution 2023-11-15
202342770210 Annual Report 2023-11-15
202342769890 Reinstatement 2023-11-15
202341443430 Revocation Certificate For Failure to File the Annual Report for the Year 2023-09-12
202337986150 Revocation Notice For Failure to File An Annual Report 2023-06-19
202215878120 Annual Report 2022-04-27
202195067350 Annual Report 2021-03-29
202039047410 Annual Report 2020-04-30
201989503960 Annual Report 2019-03-29
201866006380 Statement of Change of Registered Office by the Registered Agent 2018-05-17

Related by officers

JAMES S. LAWRENCE, ESQ.

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Related by address

No related companies by address

Date of last update: 06 Oct 2024

Sources: Rhode Island Department of State

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