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  5. Stephen S. Falkenberry, MD, Inc.

Stephen S. Falkenberry, MD, Inc.

Company Details

Name: Stephen S. Falkenberry, MD, Inc.
Jurisdiction: Rhode Island
Entity type: Domestic Profit Corporation
Status: Dissolved
Date of Organization in Rhode Island: 12 Dec 2000 (24 years ago)
Date of Dissolution: 31 Dec 2018 (6 years ago)
Date of Status Change: 31 Dec 2018 (6 years ago)
Identification Number: 000115740
ZIP code: 02905
County: Providence County
Principal Address: 235 PLAIN STREET UNIT 204, PROVIDENCE, RI, 02905, USA
Purpose: TO PROVIDE MEDICAL AND SURGICAL SERVICES TO FEMALE PATIENTS IN THE GYNECOLOGIC AND BREAST DISEASE FIELDS.
NAICS: 621111 - Offices of Physicians (except Mental Health Specialists)

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
STERPHEN S FALKENBERRY MD INC 401(K) PROFIT SHARING PLAN 2021 050514822 2024-11-11 STEPHEN S FALKENBERRY MD INC 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2001-01-01
Business code 621111
Sponsor’s telephone number 4018292275
Plan sponsor’s address 440 IVES RD, EAST GREENWICH, RI, 028184627

Signature of
Role Plan administrator
Date 2024-11-11
Name of individual signing STEPHEN FALKENBERRY
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2024-11-11
Name of individual signing STEPHEN FALKENBERRY
Valid signature Filed with authorized/valid electronic signature
STEPHEN S FALKENBERRY MD INC 401(K) PROFIT SHARING PLAN & TRUST 2020 050514822 2021-09-17 STEPHEN S FALKENBERRY MD INC 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2001-01-01
Business code 621111
Sponsor’s telephone number 4014534242
Plan sponsor’s address 440 IVES RD, EAST GREENWICH, RI, 02818

Signature of
Role Plan administrator
Date 2021-09-17
Name of individual signing STEPHEN S FALKENBERRY
Valid signature Filed with authorized/valid electronic signature
STEPHEN S FALKENBERRY MD INC 401 K PROFIT SHARING PLAN TRUST 2017 050514822 2018-05-16 STEPHEN S FALKENBERRY MD INC 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2001-01-01
Business code 621111
Sponsor’s telephone number 4014534242
Plan sponsor’s address 235 PLAIN ST STE 204, PROVIDENCE, RI, 029053241

Signature of
Role Plan administrator
Date 2018-05-16
Name of individual signing STEPHEN S FALKENBERRY,MD
Valid signature Filed with authorized/valid electronic signature
STEPHEN S FALKENBERRY MD INC 401(K) PROFIT SHARING PLAN & TRUST 2016 050514822 2017-05-19 STEPHEN S FALKENBERRY MD INC 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2001-01-01
Business code 621111
Sponsor’s telephone number 4014534242
Plan sponsor’s mailing address 235 PLAIN ST STE 204, PROVIDENCE, RI, 02905
Plan sponsor’s address 235 PLAIN ST STE 204, PROVIDENCE, RI, 02905

Number of participants as of the end of the plan year
Active participants 4
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 2
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 0
Number of participants with account balances as of the end of the plan year 5
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 0

Signature of
Role Plan administrator
Date 2017-05-19
Name of individual signing STEPHEN FALKENBERRY
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2017-05-19
Name of individual signing STEPHEN FALKENBERRY
Valid signature Filed with authorized/valid electronic signature
STEPHEN S FALKENBERRY MD INC 401(K) PROFIT SHARING PLAN & TRUST 2016 050514822 2017-05-19 STEPHEN S FALKENBERRY MD INC 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2001-01-01
Business code 621111
Sponsor’s telephone number 4014534242
Plan sponsor’s mailing address 235 PLAIN ST STE 204, PROVIDENCE, RI, 02905
Plan sponsor’s address 235 PLAIN ST STE 204, PROVIDENCE, RI, 02905

Number of participants as of the end of the plan year
Active participants 4
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 2
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 0
Number of participants with account balances as of the end of the plan year 6
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 0

Signature of
Role Plan administrator
Date 2017-05-19
Name of individual signing STEPHEN FALKENBERRY
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2017-05-19
Name of individual signing STEPHEN FALKENBERRY
Valid signature Filed with authorized/valid electronic signature
STEPHEN S FALKENBERRY MD INC 401(K) PROFIT SHARING PLAN & TRUST 2016 050514822 2017-05-19 STEPHEN S FALKENBERRY MD INC 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2001-01-01
Business code 621111
Sponsor’s telephone number 4014534242
Plan sponsor’s mailing address 235 PLAIN ST STE 204, PROVIDENCE, RI, 02905
Plan sponsor’s address 235 PLAIN ST STE 204, PROVIDENCE, RI, 02905

Number of participants as of the end of the plan year
Active participants 3
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 2
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 0
Number of participants with account balances as of the end of the plan year 5
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 0

Signature of
Role Plan administrator
Date 2017-05-19
Name of individual signing STEPHEN FALKENBERRY
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2017-05-19
Name of individual signing STEPHEN FALKENBERRY
Valid signature Filed with authorized/valid electronic signature
STEPHEN S FALKENBERRY MD INC 401(K) PROFIT SHARING PLAN & TRUST 2016 050514822 2017-05-19 STEPHEN S FALKENBERRY MD INC 0
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2001-01-01
Business code 621111
Sponsor’s telephone number 4014534242
Plan sponsor’s mailing address 235 PLAIN ST STE 204, PROVIDENCE, RI, 02905
Plan sponsor’s address 235 PLAIN ST STE 204, PROVIDENCE, RI, 02905

Number of participants as of the end of the plan year
Active participants 5
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 0
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 0
Number of participants with account balances as of the end of the plan year 5
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 0

Signature of
Role Plan administrator
Date 2017-05-19
Name of individual signing STEPHEN FALKENBERRY
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2017-05-19
Name of individual signing STEPHEN FALKENBERRY
Valid signature Filed with authorized/valid electronic signature
STEPHEN S FALKENBERRY MD INC 401(K) PROFIT SHARING PLAN & TRUST 2016 050514822 2017-05-19 STEPHEN S FALKENBERRY MD INC 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2001-01-01
Business code 621111
Sponsor’s telephone number 4014534242
Plan sponsor’s mailing address 235 PLAIN ST STE 204, PROVIDENCE, RI, 02905
Plan sponsor’s address 235 PLAIN ST STE 204, PROVIDENCE, RI, 02905

Number of participants as of the end of the plan year
Active participants 3
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 1
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 0
Number of participants with account balances as of the end of the plan year 4
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 0

Signature of
Role Plan administrator
Date 2017-05-19
Name of individual signing STEPHEN FALKENBERRY
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2017-05-19
Name of individual signing STEPHEN FALKENBERRY
Valid signature Filed with authorized/valid electronic signature
STEPHEN S FALKENBERRY MD INC 401(K) PROFIT SHARING PLAN & TRUST 2016 050514822 2017-05-19 STEPHEN S FALKENBERRY MD INC 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2001-01-01
Business code 621111
Sponsor’s telephone number 4014534242
Plan sponsor’s mailing address 235 PLAIN ST STE 204, PROVIDENCE, RI, 02905
Plan sponsor’s address 235 PLAIN ST STE 204, PROVIDENCE, RI, 02905

Number of participants as of the end of the plan year
Active participants 4
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 1
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 0
Number of participants with account balances as of the end of the plan year 5
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 0

Signature of
Role Plan administrator
Date 2017-05-19
Name of individual signing STEPHEN FALKENBERRY
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2017-05-19
Name of individual signing STEPHEN FALKENBERRY
Valid signature Filed with authorized/valid electronic signature
STEPHEN S FALKENBERRY MD INC 401(K) PROFIT SHARING PLAN & TRUST 2016 050514822 2017-05-19 STEPHEN S FALKENBERRY MD INC 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2001-01-01
Business code 621111
Sponsor’s telephone number 4014534242
Plan sponsor’s mailing address 235 PLAIN ST STE 204, PROVIDENCE, RI, 02905
Plan sponsor’s address 235 PLAIN ST STE 204, PROVIDENCE, RI, 02905

Number of participants as of the end of the plan year
Active participants 4
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 1
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 0
Number of participants with account balances as of the end of the plan year 5
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 0

Signature of
Role Plan administrator
Date 2017-05-19
Name of individual signing STEPHEN FALKENBERRY
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2017-05-19
Name of individual signing STEPHEN FALKENBERRY
Valid signature Filed with authorized/valid electronic signature
Three-digit plan number (PN) 001
Effective date of plan 2001-01-01
Business code 621111
Sponsor’s telephone number 4014534242
Plan sponsor’s mailing address 235 PLAIN ST STE 204, PROVIDENCE, RI, 02905
Plan sponsor’s address 235 PLAIN ST STE 204, PROVIDENCE, RI, 02905

Number of participants as of the end of the plan year
Active participants 3
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 2
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 0
Number of participants with account balances as of the end of the plan year 5
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 0

Signature of
Role Plan administrator
Date 2017-05-19
Name of individual signing STEPHEN FALKENBERRY
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2017/05/19/20170519131204P030030824359001.pdf
Three-digit plan number (PN) 001
Effective date of plan 2001-01-01
Business code 621111
Sponsor’s telephone number 4014534242
Plan sponsor’s mailing address 235 PLAIN ST STE 204, PROVIDENCE, RI, 02905
Plan sponsor’s address 235 PLAIN ST STE 204, PROVIDENCE, RI, 02905

Number of participants as of the end of the plan year
Active participants 4
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 0
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 0
Number of participants with account balances as of the end of the plan year 4
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 0

Signature of
Role Plan administrator
Date 2017-05-19
Name of individual signing STEPHEN FALKENBERRY
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2017-05-19
Name of individual signing STEPHEN FALKENBERRY
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2017/05/19/20170519101413P040032164359001.pdf
Three-digit plan number (PN) 001
Effective date of plan 2001-01-01
Business code 621111
Sponsor’s telephone number 4014534242
Plan sponsor’s address 235 PLAIN ST STE 204, PROVIDENCE, RI, 029053241

Signature of
Role Plan administrator
Date 2017-05-19
Name of individual signing STEPHEN FALKENBERRY
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2017-05-19
Name of individual signing STEPHEN FALKENBERRY
Valid signature Filed with authorized/valid electronic signature
Three-digit plan number (PN) 001
Effective date of plan 2001-01-01
Business code 621111
Sponsor’s telephone number 4014534242
Plan sponsor’s address 235 PLAIN ST STE 204, PROVIDENCE, RI, 029053241

Signature of
Role Plan administrator
Date 2017-05-19
Name of individual signing STEPHEN FALKENBERRY
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2017-05-19
Name of individual signing STEPHEN FALKENBERRY
Valid signature Filed with authorized/valid electronic signature
Three-digit plan number (PN) 001
Effective date of plan 2001-01-01
Business code 621111
Plan sponsor’s address 235 PLAIN ST STE 204, PROVIDENCE, RI, 029053241

Plan administrator’s name and address
Plan administrator’s name SAME

Signature of
Role Plan administrator
Date 2017-05-19
Name of individual signing STEPHEN FALKENBERRY
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2017-05-19
Name of individual signing STEPHEN FALKENBERRY
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2017/05/18/20170518165654P030000990169001.pdf
Three-digit plan number (PN) 001
Effective date of plan 2001-01-01
Business code 621111
Sponsor’s telephone number 4014534242
Plan sponsor’s address 235 PLAIN ST STE 204, PROVIDENCE, RI, 029053241

Signature of
Role Plan administrator
Date 2017-05-18
Name of individual signing STEPHEN S FALKENBERRY
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2017/05/19/20170519092754P040032089527001.pdf
Three-digit plan number (PN) 001
Effective date of plan 2001-01-01
Business code 621111
Plan sponsor’s address 235 PLAIN ST STE 204, PROVIDENCE, RI, 029053241

Plan administrator’s name and address
Plan administrator’s name SAME

Signature of
Role Plan administrator
Date 2017-05-19
Name of individual signing STEPHEN FALKENBERRY
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2017-05-19
Name of individual signing STEPHEN FALKENBERRY
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2017/05/19/20170519092250P030030426663001.pdf
Three-digit plan number (PN) 001
Effective date of plan 2001-01-01
Business code 621111
Sponsor’s telephone number 4014534242
Plan sponsor’s address 235 PLAIN ST STE 204, PROVIDENCE, RI, 029053241

Signature of
Role Plan administrator
Date 2017-05-19
Name of individual signing STEPHEN FALKENBERRY
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2017-05-19
Name of individual signing STEPHEN FALKENBERRY
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2017/05/19/20170519095151P040037309137001.pdf
Three-digit plan number (PN) 001
Effective date of plan 2001-01-01
Business code 621111
Sponsor’s telephone number 4014534242
Plan sponsor’s address 235 PLAIN ST STE 204, PROVIDENCE, RI, 029053241

Signature of
Role Plan administrator
Date 2017-05-19
Name of individual signing STEPHEN FALKENBERRY
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2017-05-19
Name of individual signing STEPHEN FALKENBERRY
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2017/05/18/20170518172531P030000990617001.pdf
Three-digit plan number (PN) 001
Effective date of plan 2001-01-01
Business code 621111
Sponsor’s telephone number 4014534242
Plan sponsor’s address 235 PLAIN ST STE 204, PROVIDENCE, RI, 029053241

Signature of
Role Plan administrator
Date 2017-05-18
Name of individual signing STEPHEN S FALKENBERRY
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2017/05/18/20170518182504P030026561293001.pdf
Three-digit plan number (PN) 001
Effective date of plan 2001-01-01
Business code 621111
Sponsor’s telephone number 4014534242
Plan sponsor’s address 235 PLAIN ST STE 204, PROVIDENCE, RI, 029053241

Signature of
Role Plan administrator
Date 2017-05-18
Name of individual signing STEPHEN S FALKENBERRY
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2017/05/18/20170518183155P030026569581001.pdf
Three-digit plan number (PN) 001
Effective date of plan 2001-01-01
Business code 621111
Sponsor’s telephone number 4014534242
Plan sponsor’s address 235 PLAIN ST STE 204, PROVIDENCE, RI, 029053241

Signature of
Role Plan administrator
Date 2017-05-18
Name of individual signing STEPHEN S FALKENBERRY
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
SHEILA M. COOLEY Agent 178 DIVISION STREET, EAST GREENWICH, RI, 02818, USA

PRESIDENT

Name Role Address
STEPHEN S. FALKENBERRY PRESIDENT 235 PLAIN STREET, UNIT 204 PROVIDENCE, RI 02905 USA

TREASURER

Name Role Address
STEPHEN S FALKENBERRY TREASURER 235 PLAIN STREET PROVIDENCE, RI 02905 USA

SECRETARY

Name Role Address
STEPHEN S. FALKENBERRY SECRETARY 235 PLAIN STREET, #204 PROVIDENCE, RI 02905 USA

VICE PRESIDENT

Name Role Address
STEPHEN S. FALKENBERRY FALKENBERRY VICE PRESIDENT 235 PLAIN STREET, #204 PROVIDENCE, RI 02905 USA

DIRECTOR

Name Role Address
STEPHEN S. FALKENBERRY DIRECTOR 235 PLAIN STREET, #204 PROVIDENCE, RI 02818 USA

Filings

Number Name File Date
201882977570 Articles of Dissolution 2018-12-20
201856267540 Annual Report 2018-01-17
201730193680 Annual Report 2017-01-17
201692100300 Annual Report 2016-02-08
201553711580 Annual Report 2015-01-14
201436475990 Annual Report 2014-02-28
201328073440 Statement of Change of Registered/Resident Agent Office 2013-09-11
201308008790 Annual Report 2013-01-08
201289832670 Annual Report 2012-02-17
201175504430 Annual Report 2011-02-22

Related by officers

SHEILA M. COOLEY

Red House Drafting & Design, Ltd. Logan Consulting, Inc. ETM Lumber & Hardware Supplies, Inc. Volunteer Guardians Program, Inc. Forty Rose Associates, Ltd. Elizabeth Tito, MD, Inc. Adult Health Associates, Inc. PFM East Coast Safety, Inc. Process Facilities Services, Inc. Strategic Fab Services, Inc.

STEPHEN S. FALKENBERRY

FALKENBERRY PROPERTIES, LLC

STEPHEN S FALKENBERRY

FALKENBERRY PROPERTIES, LLC

Related by address

No related companies by address

Date of last update: 08 Oct 2024

Sources: Rhode Island Department of State

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