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  5. WELLINGTON IMAGING ASSOCIATES, P.A.

WELLINGTON IMAGING ASSOCIATES, P.A.

Company Details

Entity Name: WELLINGTON IMAGING ASSOCIATES, P.A.
Jurisdiction: FLORIDA
Filing Type: Domestic Profit
Status: Active
Date Filed: 27 Mar 2001 (24 years ago)
Last Event: AMENDMENT
Event Date Filed: 13 Dec 2018 (6 years ago)
Document Number: P01000030971
FEI/EIN Number 651090589
Address: 2204 South Daytona Ave, Flagler Beach, FL, 32136, US
Mail Address: 2204 South Daytona Ave, Flagler Beach, FL, 32136, US
ZIP code: 32136
County: Flagler
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1689665499 2005-11-01 2022-08-22 2715 FRANK ST, EAU CLAIRE, WI, 547032593, US 524 W SAGAMORE AVE, CLEWISTON, FL, 334403514, US

Contacts
Phone +1 877-779-0693
Fax 7158345870
Phone +1 863-902-3000

Authorized person
Name SCOTT D RUEHRMUND
Role OWNER/PRESIDENT
Phone 5613581074

Taxonomy
Taxonomy Code 2085R0202X - Diagnostic Radiology Physician
Is Primary Yes

Other Provider Identifiers
Issuer BCBS
Number 45694
State FL
Issuer MEDICAID
Number 261942300
State FL

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
WELLINGTON IMAGING ASSOCIATES 401(K) AND PROFIT SHARING PLAN 2023 651090589 2024-05-16 WELLINGTON IMAGING ASSOCIATES, P.A. 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 621111
Sponsor’s telephone number 5617233859
Plan sponsor’s mailing address PO BOX 211179, ROYAL PALM BEACH, FL, 334211179
Plan sponsor’s address 250 E. CIRCLE DRIVE, CLEWISTON, FL, 33440

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 2024-05-16
Name of individual signing JACQUELINE JOHNSON
Valid signature Filed with authorized/valid electronic signature
WELLINGTON IMAGING ASSOCIATES 401(K) AND PROFIT SHARING PLAN 2022 651090589 2023-05-03 WELLINGTON IMAGING ASSOCIATES, P.A. 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 621111
Sponsor’s telephone number 5617233859
Plan sponsor’s mailing address PO BOX 211179, ROYAL PALM BEACH, FL, 334211179
Plan sponsor’s address 250 E. CIRCLE DRIVE, CLEWISTON, FL, 33440

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 2023-05-03
Name of individual signing JACQUELINE JOHNSON
Valid signature Filed with authorized/valid electronic signature
WELLINGTON IMAGING ASSOCIATES 401(K) AND PROFIT SHARING PLAN 2021 651090589 2022-06-21 WELLINGTON IMAGING ASSOCIATES, P.A. 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 621111
Sponsor’s telephone number 5617233859
Plan sponsor’s mailing address PO BOX 211179, ROYAL PALM BEACH, FL, 334211179
Plan sponsor’s address 250 E. CIRCLE DRIVE, CLEWISTON, FL, 33440

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 2022-06-21
Name of individual signing JACQUELINE JOHNSON
Valid signature Filed with authorized/valid electronic signature
WELLINGTON IMAGING ASSOCIATES 401(K) AND PROFIT SHARING PLAN 2020 651090589 2021-09-23 WELLINGTON IMAGING ASSOCIATES, P.A. 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 621111
Sponsor’s telephone number 5617233859
Plan sponsor’s mailing address PO BOX 211179, ROYAL PALM BEACH, FL, 334211179
Plan sponsor’s address 250 E. CIRCLE DRIVE, CLEWISTON, FL, 33440

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 2021-09-23
Name of individual signing JACQUELINE JOHNSON
Valid signature Filed with authorized/valid electronic signature
WELLINGTON IMAGING ASSOCIATES 401(K) AND PROFIT SHARING PLAN 2019 651090589 2020-06-16 WELLINGTON IMAGING ASSOCIATES, P.A. 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 621111
Sponsor’s telephone number 5617233859
Plan sponsor’s mailing address PO BOX 211179, ROYAL PALM BEACH, FL, 334211179
Plan sponsor’s address 17681 MIDDLEBROOK WAY, BOCA RATON, FL, 33496

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 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 3
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 2020-06-16
Name of individual signing JACQUELINE JOHNSON
Valid signature Filed with authorized/valid electronic signature
WELLINGTON IMAGING ASSOCIATES 401(K) PROFIT SHARING PLAN 2012 651090589 2013-07-25 WELLINGTON IMAGING ASSOCIATES, P.A. 19
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 621111
Sponsor’s telephone number 5617233859
Plan sponsor’s address 11337 OKEECHOBEE BLVD., SUITE A, ROYAL PALM BEACH, FL, 33411

Plan administrator’s name and address
Administrator’s EIN 651090589
Plan administrator’s name WELLINGTON IMAGING ASSOCIATES, P.A.
Plan administrator’s address 11337 OKEECHOBEE BLVD., SUITE A, ROYAL PALM BEACH, FL, 33411
Administrator’s telephone number 5617233859

Signature of
Role Plan administrator
Date 2013-07-25
Name of individual signing JACKIE JOHNSON
Valid signature Filed with authorized/valid electronic signature
WELLINGTON IMAGING ASSOCIATES 401(K) PROFIT SHARING PLAN 2012 651090589 2013-07-25 WELLINGTON IMAGING ASSOCIATES, P.A. 19
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 621111
Sponsor’s telephone number 5617233859
Plan sponsor’s address P.O. BOX 211179, ROYAL PALM BEACH, FL, 334211179

Plan administrator’s name and address
Administrator’s EIN 651090589
Plan administrator’s name WELLINGTON IMAGING ASSOCIATES, P.A.
Plan administrator’s address P.O. BOX 211179, ROYAL PALM BEACH, FL, 334211179
Administrator’s telephone number 5617233859

Signature of
Role Plan administrator
Date 2013-07-25
Name of individual signing JACKIE JOHNSON
Valid signature Filed with authorized/valid electronic signature
WELLINGTON IMAGING ASSOCIATES 401(K) PROFIT SHARING PLAN 2011 651090589 2012-10-08 WELLINGTON IMAGING ASSOCIATES, P.A. 29
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 621111
Sponsor’s telephone number 5617233859
Plan sponsor’s address 11337 OKEECHOBEE BLVD., SUITE A, ROYAL PALM BEACH, FL, 33411

Plan administrator’s name and address
Administrator’s EIN 651090589
Plan administrator’s name WELLINGTON IMAGING ASSOCIATES, P.A.
Plan administrator’s address 11337 OKEECHOBEE BLVD., SUITE A, ROYAL PALM BEACH, FL, 33411
Administrator’s telephone number 5617233859

Signature of
Role Plan administrator
Date 2012-10-08
Name of individual signing ADAM MANDEL
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2012-10-08
Name of individual signing ADAM MANDEL
Valid signature Filed with authorized/valid electronic signature
WELLINGTON IMAGING ASSOCIATES 401(K) PROFIT SHARING PLAN 2010 651090589 2011-09-09 WELLINGTON IMAGING ASSOCIATES, P.A. 38
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 621111
Sponsor’s telephone number 5617233859
Plan sponsor’s address 11337 OKEECHOBEE BLVD., SUITE A, ROYAL PALM BEACH, FL, 33411

Plan administrator’s name and address
Administrator’s EIN 651090589
Plan administrator’s name WELLINGTON IMAGING ASSOCIATES, P.A.
Plan administrator’s address 11337 OKEECHOBEE BLVD., SUITE A, ROYAL PALM BEACH, FL, 33411
Administrator’s telephone number 5617233859

Signature of
Role Plan administrator
Date 2011-09-09
Name of individual signing JOHNSON
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2011-09-09
Name of individual signing JOHNSON
Valid signature Filed with authorized/valid electronic signature
WELLINGTON IMAGING ASSOCIATES 401(K) PROFIT SHARING PLAN 2009 651090589 2010-10-12 WELLINGTON IMAGING ASSOCIATES, P.A. 45
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 621111
Sponsor’s telephone number 5617233859
Plan sponsor’s address 11337 OKEECHOBEE BLVD., SUITE A, ROYAL PALM BEACH, FL, 33411

Plan administrator’s name and address
Administrator’s EIN 651090589
Plan administrator’s name WELLINGTON IMAGING ASSOCIATES, P.A.
Plan administrator’s address 11337 OKEECHOBEE BLVD., SUITE A, ROYAL PALM BEACH, FL, 33411
Administrator’s telephone number 5617233859

Signature of
Role Plan administrator
Date 2010-10-12
Name of individual signing JOHNSON
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2010-10-12
Name of individual signing JOHNSON
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
RUEHRMUND SCOTT D Agent 2204 South Daytona Ave, Flagler Beach, FL, 32136

President

Name Role Address
RUEHRMUND SCOTT D President 2204 South Daytona Ave, Flagler Beach, FL, 32136

Events

Event Type Filed Date Value Description
CHANGE OF PRINCIPAL ADDRESS 2024-02-08 2204 South Daytona Ave, Flagler Beach, FL 32136 No data
CHANGE OF MAILING ADDRESS 2024-02-08 2204 South Daytona Ave, Flagler Beach, FL 32136 No data
REGISTERED AGENT ADDRESS CHANGED 2024-02-08 2204 South Daytona Ave, Flagler Beach, FL 32136 No data
AMENDMENT 2018-12-13 No data No data
REGISTERED AGENT NAME CHANGED 2018-12-13 RUEHRMUND, SCOTT D No data

Documents

Name Date
ANNUAL REPORT 2024-02-08
ANNUAL REPORT 2023-01-23
ANNUAL REPORT 2022-03-21
ANNUAL REPORT 2021-02-23
ANNUAL REPORT 2020-02-02
ANNUAL REPORT 2019-04-09
Amendment 2018-12-13
ANNUAL REPORT 2018-02-18
ANNUAL REPORT 2017-01-23
ANNUAL REPORT 2016-03-10

Related by officers

No related officers

Related by address

No related companies by address

Date of last update: 01 Feb 2025

Sources: Florida Department of State

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