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PHOENIX RADIOLOGY PLLC

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Company Details

Name: PHOENIX RADIOLOGY PLLC
Jurisdiction: Idaho
Legal type: Limited Liability Company (D)
Status: Active-Existing
Date of registration: 15 Jul 2004 (21 years ago)
Financial Date End: 31 Jul 2026
Entity Number: 108501
Place of Formation: IDAHO
File Number: 108501
ZIP code: 83501
County: Nez Perce County
Principal Address: 531 4TH AVE LEWISTON, ID 83501
Mailing Address: 531 4TH AVE LEWISTON, ID 83501-2450

Agent

Name Role Address
Paul J Sanchirico Agent 531 4TH AVE, ID, LEWISTON, ID 83501

Member

Name Role Address Appointed On Resigned On
PAUL SANCHIRICO Member 531 4TH AVE, LEWISTON, ID 83501 2020-07-02 No data
GREGORY SPURLING Member 531 4TH AVE, LEWISTON, ID 83501 2023-07-12 2024-07-10
DALLEN ASHBY Member 531 4TH AVE, LEWISTON, ID 83501 2023-07-12 2024-07-10
MICHAEL BURTIS Member 531 4TH AVE, LEWISTON, ID 83501 2023-07-12 2024-07-10

Unique Entity ID

Unique Entity ID:
D7CQJDTLCET5
UEI Expiration Date:
2023-08-24

Business Information

Activation Date:
2022-08-26
Initial Registration Date:
2022-07-25

National Provider Identifier

NPI Number:
1164493334

Authorized Person:

Name:
DR. MARK W PETERSON
Role:
OWNER
Phone:

Taxonomy:

Selected Taxonomy:
2085R0202X - Diagnostic Radiology Physician
Is Primary:
No
Selected Taxonomy:
2085R0204X - Vascular & Interventional Radiology Physician
Is Primary:
No

Contacts:

Fax:
2087434214

Form 5500 Series

Employer Identification Number (EIN):
201383479
Plan Year:
2024
Number Of Participants:
13
Sponsors Telephone Number:
Plan Year:
2023
Number Of Participants:
13
Sponsors Telephone Number:
Plan Year:
2022
Number Of Participants:
14
Sponsors Telephone Number:
Plan Year:
2021
Number Of Participants:
10
Sponsors Telephone Number:
Plan Year:
2020
Number Of Participants:
12
Sponsors Telephone Number:

Filing

Filing Name Filing Number Filing date
Annual Report 0006367742 2025-07-22
Annual Report 0005815882 2024-07-10
Annual Report 0005317628 2023-07-12
Annual Report 0004822921 2022-07-14
Annual Report 0004346428 2021-07-13

USAspending Awards / Financial Assistance

Date:
2020-04-13
Awarding Agency Name:
Small Business Administration
Transaction Description:
TO AID SMALL BUSINESSES IN MAINTAINING WORK FORCE DURING COVID-19 PANDEMIC.
Obligated Amount:
0.00
Face Value Of Loan:
121800.00
Total Face Value Of Loan:
121800.00

Paycheck Protection Program

Jobs Reported:
11
Initial Approval Amount:
$121,800
Date Approved:
2020-04-11
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Current Approval Amount:
$121,800
Race:
Unanswered
Ethnicity:
Unknown/NotStated
Gender:
Unanswered
Veteran:
Unanswered
Forgiveness Amount:
$122,954.6
Servicing Lender:
Zions Bank, A Division of
Use of Proceeds:
Payroll: $121,800

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Date of last update: 31 Jul 2025

Sources: Idaho Secretary of State