| Name: | David P. Carter, M.D., Inc. |
| Jurisdiction: | Rhode Island |
| Entity type: | Domestic Profit Corporation |
| Status: | Dissolved |
| Date of Organization in Rhode Island: | 22 May 1992 (33 years ago) |
| Date of Dissolution: | 25 Jan 2013 (12 years ago) |
| Date of Status Change: | 25 Jan 2013 (12 years ago) |
| Identification Number: | 000068352 |
| ZIP code: | 02860 |
| County: | Providence County |
| Principal Address: | 174 ARMISTICE BOULEVARD, PAWTUCKET, RI, 02860, USA |
| Purpose: | PROVIDE PROFESSIONAL MEDICAL SERVICES |
| Historical names: |
FAMILY MEDICINE SPECIALISTS, INC. |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1174533756 | 2006-08-08 | 2020-08-22 | 174 ARMISTICE BLVD, PAWTUCKET, RI, 02860, US | 174 ARMISTICE BLVD, PAWTUCKET, RI, 02860, US | |||||||||||||||
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| Phone | +1 401-723-7578 |
| Fax | 4017261990 |
Authorized person
| Name | DAVID P CARTER |
| Role | PRESIDENT |
| Phone | 4017237578 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| Is Primary | Yes |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| FAMILY MEDICINE SPECIALISTS, INC. RETIREMENT PLAN | 2010 | 050466303 | 2010-09-15 | FAMILY MEDICINE SPECIALISTS, INC. | 6 | |||||||||||||||||||||||||||||||||||||||||
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| Administrator’s EIN | 050466303 |
| Plan administrator’s name | FAMILY MEDICINE SPECIALISTS, INC. |
| Plan administrator’s address | 174 ARMISTICE BOULEVARD, PAWTUCKET, RI, 02860 |
| Administrator’s telephone number | 4017236957 |
Signature of
| Role | Plan administrator |
| Date | 2010-09-15 |
| Name of individual signing | DAVID P. CARTER, MD |
| Valid signature | Filed with authorized/valid electronic signature |
| Role | Employer/plan sponsor |
| Date | 2010-09-15 |
| Name of individual signing | DAVID P. CARTER, MD |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 1990-01-01 |
| Business code | 621111 |
| Sponsor’s telephone number | 4017236957 |
| Plan sponsor’s address | 174 ARMISTICE BOULEVARD, PAWTUCKET, RI, 02860 |
Plan administrator’s name and address
| Administrator’s EIN | 050466303 |
| Plan administrator’s name | FAMILY MEDICINE SPECIALISTS, INC. |
| Plan administrator’s address | 174 ARMISTICE BOULEVARD, PAWTUCKET, RI, 02860 |
| Administrator’s telephone number | 4017236957 |
Signature of
| Role | Plan administrator |
| Date | 2010-07-15 |
| Name of individual signing | DAVID CARTER |
| Valid signature | Filed with authorized/valid electronic signature |
| Role | Employer/plan sponsor |
| Date | 2010-07-14 |
| Name of individual signing | DAVID CARTER |
| Valid signature | Filed with authorized/valid electronic signature |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 1990-01-01 |
| Business code | 621111 |
| Sponsor’s telephone number | 4017236957 |
| Plan sponsor’s address | 174 ARMISTICE BOULEVARD, PAWTUCKET, RI, 02860 |
Plan administrator’s name and address
| Administrator’s EIN | 050466303 |
| Plan administrator’s name | FAMILY MEDICINE SPECIALISTS, INC. |
| Plan administrator’s address | 174 ARMISTICE BOULEVARD, PAWTUCKET, RI, 02860 |
| Administrator’s telephone number | 4017236957 |
Signature of
| Role | Employer/plan sponsor |
| Date | 2010-07-14 |
| Name of individual signing | DAVID CARTER |
| Valid signature | Filed with authorized/valid electronic signature |
| Name | Role | Address |
|---|---|---|
| DAVID P. CARTER, M.D. | Agent | 174 ARMISTICE BOULEVARD, PAWTUCKET, RI, 02860, USA |
| Name | Role | Address |
|---|---|---|
| DAVID P CARTER MD | PRESIDENT | 174 ARMISTICE BOULEVARD PAWTUCKET, RI 02860 USA |
| Type | Date | Old Value | New Value |
|---|---|---|---|
| Name Change | 2012-01-03 | FAMILY MEDICINE SPECIALISTS, INC. | David P. Carter, M.D., Inc. |
| Number | Name | File Date |
|---|---|---|
| 201310328550 | Articles of Dissolution | 2013-01-25 |
| 201288048270 | Annual Report | 2012-01-17 |
| 201287489740 | Articles of Amendment | 2012-01-03 |
| 201176371130 | Annual Report | 2011-03-09 |
| 201176371040 | Statement of Change of Registered/Resident Agent | 2011-03-09 |
| 201058561680 | Annual Report | 2010-02-16 |
| 200941253200 | Annual Report | 2009-01-26 |
| 200805759260 | Annual Report | 2008-01-14 |
Date of last update: 07 Oct 2024
Sources: Rhode Island Department of State
