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UNIVERSITY CONCIERGE MEDICINE, LLC

Company Details

Name: UNIVERSITY CONCIERGE MEDICINE, LLC
Jurisdiction: Rhode Island
Entity type: Domestic Limited Liability Company
Status: Activ
Date of Organization in Rhode Island: 17 Nov 2016 (8 years ago)
Identification Number: 001668535
ZIP code: 02842
County: Newport County
Principal Address: 1 CORPORATE PLACE 1ST FLOOR, MIDDLETOWN, RI, 02842, USA
Purpose: CONCIERGE MEDICAL PRACTICE
NAICS: 621111 - Offices of Physicians (except Mental Health Specialists)
Fictitious names: Newport Personalized Medicine (trading name, 2016-11-17 - )

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1992239081 2017-04-14 2017-06-22 1 CORPORATE PL, MIDDLETOWN, RI, 028426406, US 1 CORPORATE PL, MIDDLETOWN, RI, 028426406, US

Contacts

Phone +1 401-619-4884
Fax 4016194886

Authorized person

Name DR. DAVID FRANCIS CUNNINGHAM
Role OWNER
Phone 4016194884

Taxonomy

Taxonomy Code 207R00000X - Internal Medicine Physician
License Number 7724
State RI
Is Primary Yes

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
UNIVERSITY CONCIERGE MEDICINE, LLC 401(K) PLAN 2023 814940322 2024-05-16 UNIVERSITY CONCIERGE MEDICINE, LLC 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2018-01-01
Business code 621111
Sponsor’s telephone number 4018480000
Plan sponsor’s address 1 CORPORATE PLACE, 1ST FLOOR, MIDDLETOWN, RI, 02842

Signature of

Role Plan administrator
Date 2024-05-16
Name of individual signing DAVID F. CUNNINGHAM
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2024-05-16
Name of individual signing DAVID F. CUNNINGHAM
Valid signature Filed with authorized/valid electronic signature
UNIVERSITY CONCIERGE MEDICINE, LLC 401(K) PLAN 2022 814940322 2023-05-02 UNIVERSITY CONCIERGE MEDICINE, LLC 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2018-01-01
Business code 621111
Sponsor’s telephone number 4018480000
Plan sponsor’s address 1 CORPORATE PLACE, 1ST FLOOR, MIDDLETOWN, RI, 02842

Signature of

Role Plan administrator
Date 2023-05-02
Name of individual signing DAVID F. CUNNINGHAM
Valid signature Filed with authorized/valid electronic signature
UNIVERSITY CONCIERGE MEDICINE, LLC 401(K) PLAN 2021 814940322 2022-06-28 UNIVERSITY CONCIERGE MEDICINE, LLC 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2018-01-01
Business code 621111
Sponsor’s telephone number 4018480000
Plan sponsor’s address 1 CORPORATE PLACE, 1ST FLOOR, MIDDLETOWN, RI, 02842

Signature of

Role Plan administrator
Date 2022-06-28
Name of individual signing DAVID F. CUNNINGHAM
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2022-06-28
Name of individual signing DAVID F. CUNNINGHAM
Valid signature Filed with authorized/valid electronic signature
UNIVERSITY CONCIERGE MEDICINE, LLC 401(K) PL 2020 814940322 2021-05-21 UNIVERSITY CONCIERGE MEDICINE, LLC 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2018-01-01
Business code 621111
Sponsor’s telephone number 4018480000
Plan sponsor’s address 1 CORPORATE PLACE, 1ST FLOOR, MIDDLETOWN, RI, 02842

Signature of

Role Plan administrator
Date 2021-05-21
Name of individual signing DAVID F CUNNINGHAM
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2021-05-21
Name of individual signing DAVID F CUNNINGHAM
Valid signature Filed with authorized/valid electronic signature
UNIVERSITY CONCIERGE MEDICINE, LLC 401(K) PL 2019 814940322 2020-06-23 UNIVERSITY CONCIERGE MEDICINE, LLC 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2018-01-01
Business code 621111
Sponsor’s telephone number 4018480000
Plan sponsor’s address 1 CORPORATE PLACE, 1ST FLOOR, MIDDLETOWN, RI, 02842

Signature of

Role Plan administrator
Date 2020-06-23
Name of individual signing DAVID CUNNINGHAM
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2020-06-23
Name of individual signing DAVID CUNNINGHAM
Valid signature Filed with authorized/valid electronic signature
UNIVERSITY CONCIERGE MEDICINE, LLC 401(K) PL 2018 814940322 2019-06-11 UNIVERSITY CONCIERGE MEDICINE, LLC 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2018-01-01
Business code 621111
Sponsor’s telephone number 4018480000
Plan sponsor’s address 1 CORPORATE PLACE, 1ST FLOOR, MIDDLETOWN, RI, 02842

Signature of

Role Plan administrator
Date 2019-06-11
Name of individual signing DAVID F. CUNNINGHAM
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2019-06-11
Name of individual signing DAVID F. CUNNINGHAM
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
JENNIFER C. CAPODILUPO, CPA Agent 1 CORPORATE PLACE, MIDDLETOWN, RI, 02842, USA

Filings

Number Name File Date
202449054510 Annual Report 2024-03-21
202330781220 Annual Report 2023-03-14
202213097910 Annual Report 2022-03-19
202104008900 Annual Report 2021-10-27
202066682840 Annual Report 2020-10-20
201924735670 Annual Report 2019-10-18
201879537770 Annual Report 2018-10-16
201752052060 Annual Report 2017-10-23
201738169920 Statement of Change of Registered/Resident Agent 2017-03-17
201612199920 Fictitious Business Name Statement 2016-11-17

Date of last update: 26 Oct 2024

Sources: Rhode Island Department of State