0001699350-23-000001.txt : 20230222 0001699350-23-000001.hdr.sgml : 20230222 20230222155729 ACCESSION NUMBER: 0001699350-23-000001 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b FILED AS OF DATE: 20230222 DATE AS OF CHANGE: 20230222 EFFECTIVENESS DATE: 20230222 FILER: COMPANY DATA: COMPANY CONFORMED NAME: SHOULDER INNOVATIONS, INC. CENTRAL INDEX KEY: 0001699350 IRS NUMBER: 270538764 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-474039 FILM NUMBER: 23652978 BUSINESS ADDRESS: STREET 1: 13827 PORT SHELDON STREET CITY: HOLLAND STATE: MI ZIP: 49424 BUSINESS PHONE: 616-566-0286 MAIL ADDRESS: STREET 1: 13827 PORT SHELDON STREET CITY: HOLLAND STATE: MI ZIP: 49424 D 1 primary_doc.xml X0708 D LIVE 0001699350 SHOULDER INNOVATIONS, INC. 220 Lyon NW Suite 500 Grand Rapids MI MICHIGAN 49503 616-566-0286 DELAWARE None None Corporation true Matthew Ahearn C/O Shoulder Innovations, Inc. 220 Lyon NW, Suite 500 Grand Rapids MI MICHIGAN 49503 Executive Officer Director Robert Ball C/O Shoulder Innovations, Inc. 220 Lyon NW, Suite 500 Grand Rapids MI MICHIGAN 49503 Executive Officer Director David Blue C/O Shoulder Innovations, Inc. 220 Lyon NW, Suite 500 Grand Rapids MI MICHIGAN 49503 Executive Officer Casey Tansey C/O Shoulder Innovations, Inc. 220 Lyon NW, Suite 500 Grand Rapids MI MICHIGAN 49503 Director Mike Carusi C/O Shoulder Innovations, Inc. 220 Lyon NW, Suite 500 Grand Rapids MI MICHIGAN 49503 Director Kevin Sidow c/o Shoulder Innovations, Inc. 220 Lyon NW, Suite 500 Grand Rapids MI MICHIGAN 49503 Director Paul Buckman c/o Shoulder Innovations, Inc. 220 Lyon NW, Suite 500 Grand Rapids MI MICHIGAN 49503 Director Geoff Pardo c/o Shoulder Innovations, Inc. 220 Lyon NW, Suite 500 Grand Rapids MI MICHIGAN 49503 Director Other Health Care Decline to Disclose 06b false 2023-02-10 false true false 0 39821690 32229523 7592167 false 21 0 0 0 false SHOULDER INNOVATIONS, INC. /s/ Matthew Ahearn Matthew Ahearn COO and CFO 2023-02-22