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  5. Olympic Physical Therapy & Sports Medicine, Inc.

Olympic Physical Therapy & Sports Medicine, Inc.

Company Details

Name: Olympic Physical Therapy & Sports Medicine, Inc.
Jurisdiction: Rhode Island
Entity type: Professional Service Corporation
Status: Activ
Date of Organization in Rhode Island: 22 May 2000 (25 years ago)
Identification Number: 000112623
ZIP code: 02842
County: Newport County
Principal Address: 1181 AQUIDNECK AVENUE, MIDDLETOWN, RI, 02842, USA
Purpose: PROFESSIONAL SERVICES BY PHYSICAL THERAPISTS
NAICS: 621340 - Offices of Physical, Occupational and Speech Therapists, and Audiologists

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1912099938 2006-09-28 2008-10-07 OLYMPIC PHYSICAL THERAPY, 1181 AQUIDNECK AVE, MIDDLETOWN, RI, 02842, US OLYMPIC PHYSICAL THERAPY, 1181 AQUIDNECK AVE, MIDDLETOWN, RI, 02842, US

Contacts
Phone +1 401-845-0840
Fax 4018450842

Authorized person
Name KIRSTIN COLLINS
Role MEDICAL BILLING
Phone 4018450840

Taxonomy
Taxonomy Code 225100000X - Physical Therapist
License Number PT02061
State RI
Is Primary Yes

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
OLYMPIC PHYSICAL THERAPY & SPORTS MEDICINE, INC. 401(K) RETIREMENT PLAN 2023 050511546 2024-10-29 OLYMPIC PHYSICAL THERAPY & SPORTS MEDICINE, INC. 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2001-01-01
Business code 621340
Sponsor’s telephone number 4018450840
Plan sponsor’s address 1181 AQUIDNECK AVENUE, MIDDLETOWN, RI, 028425283
OLYMPIC PHYSICAL THERAPY & SPORTS MEDICINE, INC. 401(K) RETIREMENT PLAN 2022 050511546 2024-10-29 OLYMPIC PHYSICAL THERAPY & SPORTS MEDICINE, INC. 9
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2001-01-01
Business code 621340
Sponsor’s telephone number 4018450840
Plan sponsor’s address 1181 AQUIDNECK AVENUE, MIDDLETOWN, RI, 028425283
OLYMPIC PHYSICAL THERAPY & SPORTS MEDICINE, INC. 401(K) RETIREMENT PLAN 2021 050511546 2022-07-05 OLYMPIC PHYSICAL THERAPY & SPORTS MEDICINE, INC. 9
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2001-01-01
Business code 621340
Sponsor’s telephone number 4018450840
Plan sponsor’s address 1181 AQUIDNECK AVENUE, MIDDLETOWN, RI, 028425283
OLYMPIC PHYSICAL THERAPY & SPORTS MEDICINE, INC. 401(K) RETIREMENT PLAN 2020 050511546 2021-10-04 OLYMPIC PHYSICAL THERAPY & SPORTS MEDICINE, INC. 38
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2001-01-01
Business code 621340
Sponsor’s telephone number 4018450840
Plan sponsor’s address 1181 AQUIDNECK AVENUE, MIDDLETOWN, RI, 028425283
OLYMPIC PHYSICAL THERAPY & SPORTS MEDICINE, INC. 401(K) RETIREMENT PLAN 2019 050511546 2020-05-28 OLYMPIC PHYSICAL THERAPY & SPORTS MEDICINE, INC. 46
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2001-01-01
Business code 621340
Sponsor’s telephone number 4018450840
Plan sponsor’s address 1181 AQUIDNECK AVENUE, MIDDLETOWN, RI, 028425283
OLYMPIC PHYSICAL THERAPY & SPORTS MEDICINE, INC. 401(K) RETIREMENT PLAN 2018 050511546 2019-04-15 OLYMPIC PHYSICAL THERAPY & SPORTS MEDICINE, INC. 40
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2001-01-01
Business code 621340
Sponsor’s telephone number 4018450840
Plan sponsor’s address 1181 AQUIDNECK AVENUE, MIDDLETOWN, RI, 028425283
OLYMPIC PHYSICAL THERAPY & SPORTS MEDICINE, INC. 401(K) RETIREMENT PLAN 2017 050511546 2018-02-17 OLYMPIC PHYSICAL THERAPY & SPORTS MEDICINE, INC. 40
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2001-01-01
Business code 621340
Sponsor’s telephone number 4018450840
Plan sponsor’s address 1181 AQUIDNECK AVENUE, MIDDLETOWN, RI, 028425283
OLYMPIC PHYSICAL THERAPY & SPORTS MEDICINE, INC. 401(K) RETIREMENT PLAN 2016 050511546 2017-07-20 OLYMPIC PHYSICAL THERAPY & SPORTS MEDICINE, INC. 35
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2001-01-01
Business code 621340
Sponsor’s telephone number 4018450840
Plan sponsor’s address 1181 AQUIDNECK AVENUE, MIDDLETOWN, RI, 028425283
OLYMPIC PHYSICAL THERAPY & SPORTS MEDICINE, INC. 401(K) RETIREMENT PLAN 2015 050511546 2016-05-09 OLYMPIC PHYSICAL THERAPY & SPORTS MEDICINE, INC. 35
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2001-01-01
Business code 621340
Sponsor’s telephone number 4018450840
Plan sponsor’s address 1181 AQUIDNECK AVENUE, MIDDLETOWN, RI, 028425283

Plan administrator’s name and address
Administrator’s EIN 050511546
Plan administrator’s name OLYMPIC PHYSICAL THERAPY & SPORTS MEDICINE, INC.
Plan administrator’s address 1181 AQUIDNECK AVENUE, MIDDLETOWN, RI, 028425283
Administrator’s telephone number 4018450840
OLYMPIC PHYSICAL THERAPY & SPORTS MEDICINE, INC. 401(K) RETIREMENT PLAN 2014 050511546 2015-06-17 OLYMPIC PHYSICAL THERAPY & SPORTS MEDICINE, INC. 45
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2001-01-01
Business code 621340
Sponsor’s telephone number 4018450840
Plan sponsor’s address 1181 AQUIDNECK AVENUE, MIDDLETOWN, RI, 028425283

Plan administrator’s name and address
Administrator’s EIN 050511546
Plan administrator’s name OLYMPIC PHYSICAL THERAPY & SPORTS MEDICINE, INC.
Plan administrator’s address 1181 AQUIDNECK AVENUE, MIDDLETOWN, RI, 028425283
Administrator’s telephone number 4018450840

Signature of
Role Plan administrator
Date 2015-06-17
Name of individual signing DONALD H. LEVINE
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2014/08/14/20140814102739P030033201133001.pdf
Three-digit plan number (PN) 001
Effective date of plan 2001-01-01
Business code 621340
Sponsor’s telephone number 4018450840
Plan sponsor’s address 1181 AQUIDNECK AVENUE, MIDDLETOWN, RI, 028425283

Plan administrator’s name and address
Administrator’s EIN 050511546
Plan administrator’s name OLYMPIC PHYSICAL THERAPY & SPORTS MEDICINE, INC.
Plan administrator’s address 1181 AQUIDNECK AVENUE, MIDDLETOWN, RI, 028425283
Administrator’s telephone number 4018450840

Signature of
Role Plan administrator
Date 2014-08-14
Name of individual signing DONALD H. LEVINE
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2013/04/08/20130408075315P040009203424001.pdf
Three-digit plan number (PN) 001
Effective date of plan 2001-01-01
Business code 621340
Sponsor’s telephone number 4018450840
Plan sponsor’s address 1181 AQUIDNECK AVENUE, MIDDLETOWN, RI, 028425283

Plan administrator’s name and address
Administrator’s EIN 050511546
Plan administrator’s name OLYMPIC PHYSICAL THERAPY & SPORTS MEDICINE, INC.
Plan administrator’s address 1181 AQUIDNECK AVENUE, MIDDLETOWN, RI, 028425283

Signature of
Role Plan administrator
Date 2013-04-08
Name of individual signing DONALD H LEVINE
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2012/04/18/20120418144012P040320471664001.pdf
Three-digit plan number (PN) 001
Effective date of plan 2001-01-01
Business code 621340
Sponsor’s telephone number 4018450840
Plan sponsor’s address 1181 AQUIDNECK AVENUE, MIDDLETOWN, RI, 028425283

Plan administrator’s name and address
Administrator’s EIN 050511546
Plan administrator’s name OLYMPIC PHYSICAL THERAPY & SPORTS MEDICINE, INC.
Plan administrator’s address 1181 AQUIDNECK AVENUE, MIDDLETOWN, RI, 028425283
Administrator’s telephone number 4018450840

Signature of
Role Plan administrator
Date 2012-04-18
Name of individual signing DONALD H. LEVINE
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2011/02/21/20110221081522P040013959697001.pdf
Three-digit plan number (PN) 001
Effective date of plan 2001-01-01
Business code 621340
Sponsor’s telephone number 4018450840
Plan sponsor’s address 1181 AQUIDNECK AVENUE, MIDDLETOWN, RI, 028425283

Plan administrator’s name and address
Administrator’s EIN 050511546
Plan administrator’s name OLYMPIC PHYSICAL THERAPY & SPORTS MEDICINE, INC.
Plan administrator’s address 1181 AQUIDNECK AVENUE, MIDDLETOWN, RI, 028425283
Administrator’s telephone number 4018450840

Signature of
Role Plan administrator
Date 2011-02-21
Name of individual signing DONALD H. LEVINE
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2010/04/29/20100429093958P040228713841001.pdf
Three-digit plan number (PN) 001
Effective date of plan 2001-01-01
Business code 621340
Sponsor’s telephone number 4018450840
Plan sponsor’s address 1181 AQUIDNECK AVENUE, MIDDLETOWN, RI, 028425283

Plan administrator’s name and address
Administrator’s EIN 050511546
Plan administrator’s name OLYMPIC PHYSICAL THERAPY & SPORTS MEDICINE, INC.
Plan administrator’s address 1181 AQUIDNECK AVENUE, MIDDLETOWN, RI, 028425283
Administrator’s telephone number 4018450840

Signature of
Role Plan administrator
Date 2010-04-29
Name of individual signing DONALD H. LEVINE
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2010-04-29
Name of individual signing DONALD H. LEVINE
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
MICHAEL RICHARDS, ESQ. Agent 36 WASHINGTON SQUARE, NEWPORT, RI, 02840, USA

PRESIDENT

Name Role Address
DONALD H LEVINE PRESIDENT 18 HIGH HAWK ROAD PORTSMOUTH, RI 02871- USA

Filings

Number Name File Date
202454958180 Annual Report 2024-05-29
202340144950 Statement of Change of Registered/Resident Agent 2023-08-04
202332202480 Annual Report 2023-03-31
202211238360 Annual Report 2022-02-17
202187729330 Annual Report 2021-01-25
202033278450 Annual Report 2020-01-27
201985441040 Annual Report 2019-01-28
201856614380 Annual Report 2018-01-22
201735182030 Annual Report 2017-02-27
201690701130 Annual Report 2016-01-14

Related by officers

No related officers

Related by address

1181 AQUIDNECK AVENUE, MIDDLETOWN, RI, 02842, USA

TRINITY-PT PARTNERS LLC

Date of last update: 08 Oct 2024

Sources: Rhode Island Department of State

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