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ALLIANCE MEDICAL GROUP, LLC

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Company Details

Name: ALLIANCE MEDICAL GROUP, LLC
Jurisdiction: Idaho
Legal type: Limited Liability Company (D)
Status: Active-Existing
Date of registration: 07 Apr 2005 (20 years ago)
Financial Date End: 30 Apr 2026
Entity Number: 127707
Place of Formation: IDAHO
File Number: 127707
ZIP code: 83714
County: Ada County
Principal Address: 10482 W CARLTON BAY DR. GARDEN CITY, ID 83714
Mailing Address: 10482 W CARLTON BAY DR GARDEN CITY, ID 83714-5143

Agent

Name Role Address
Nicholas L Taylor Agent 101 S CAPITOL BLVD, SUITE 1100, DORSEY & WHITNEY LLP, BOISE, ID 83702

Manager

Name Role Address Appointed On Resigned On
David Peterman Manager 10482 W CARLTON BAY DR, GARDEN CITY, ID 83714 2021-05-24 2023-03-06
Dan Reed Manager 10482 W CARLTON BAY DR, GARDEN CITY, ID 83714 2023-03-06 No data

Unique Entity ID

A UEI is a government-provided number, like a tax ID number, that’s used to identify businesses eligible for federal grants, awards and contracts.

Note: In April 2022, the federal government replaced its old identifier of choice, the Data Universal Numbering System (DUNS) number, with a government-issued UEI. Now all the federal government’s Integrated Award Environment systems use UEI numbers instead of DUNS numbers. So any entity doing business with the federal government must register for a UEI.

Unique Entity ID:
GFWSPBJL18X3
CAGE Code:
4Z2B3
UEI Expiration Date:
2026-02-04

Business Information

Doing Business As:
ALLIANCE MEDICAL GROUP LLC
Activation Date:
2025-02-06
Initial Registration Date:
2008-01-30

National Provider Identifier

NPI Number:
1700644812
Certification Date:
2025-02-17

Authorized Person:

Name:
LINDA BARNES
Role:
CREDENTIALING MANAGER
Phone:

Taxonomy:

Selected Taxonomy:
207Y00000X - Otolaryngology Physician
Is Primary:
Yes

Contacts:

Fax:
2089556503
Fax:
2088092896

Form 5500 Series

Employer Identification Number (EIN):
202630141
Plan Year:
2023
Number Of Participants:
488
Sponsors DBA Name:
PRIMARY HEALTH MEDICAL GROUP
Sponsors Telephone Number:
Plan Year:
2022
Number Of Participants:
467
Sponsors DBA Name:
PRIMARY HEALTH MEDICAL GROUP
Sponsors Telephone Number:
Plan Year:
2021
Number Of Participants:
666
Sponsors DBA Name:
PRIMARY HEALTH MEDICAL GROUP
Sponsors Telephone Number:
Plan Year:
2020
Number Of Participants:
673
Sponsors DBA Name:
PRIMARY HEALTH MEDICAL GROUP
Sponsors Telephone Number:
Plan Year:
2019
Number Of Participants:
640
Sponsors DBA Name:
PRIMARY HEALTH MEDICAL GROUP
Sponsors Telephone Number:

Filing

Filing Name Filing Number Filing date
Annual Report 0006153907 2025-03-10
Annual Report 0005629681 2024-03-04
Change of Registered Office/Agent/Both (by Entity) 0005324164 2023-07-20
Annual Report 0005138121 2023-03-06
Annual Report 0004628296 2022-03-03

USAspending Awards / Contracts

Procurement Instrument Identifier:
INL13PB00191
Award Or Idv Flag:
AWARD
Award Type:
BPA
Action Obligation:
8000.00
Base And Exercised Options Value:
8000.00
Base And All Options Value:
8000.00
Awarding Agency Name:
Department of the Interior
Performance Start Date:
2013-03-01
Description:
IGF::OT::IGF FIRE&AVIATION FIREFIGHTER EXAMS
Naics Code:
621111: OFFICES OF PHYSICIANS (EXCEPT MENTAL HEALTH SPECIALISTS)
Product Or Service Code:
Q201: MEDICAL- GENERAL HEALTH CARE
Procurement Instrument Identifier:
INL13PA00027
Award Or Idv Flag:
IDV
Action Obligation:
0.00
Base And Exercised Options Value:
0.00
Base And All Options Value:
0.00
Awarding Agency Name:
Department of the Interior
Performance Start Date:
2013-02-22
Description:
IGF::OT::IGF FIREFIGHTER MEDICAL EXAMS
Naics Code:
621111: OFFICES OF PHYSICIANS (EXCEPT MENTAL HEALTH SPECIALISTS)
Product Or Service Code:
Q201: MEDICAL- GENERAL HEALTH CARE

USAspending Awards / Financial Assistance

Date:
2020-04-14
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:
6375400.00
Total Face Value Of Loan:
6375400.00

Trademarks Section

Serial Number:
75202589
Mark:
PRIMARY HEALTH
Status:
The registration has been renewed.
Mark Type:
Service Mark
Application Filing Date:
1996-11-21
Mark Drawing Type:
3 - AN ILLUSTRATION DRAWING WHICH INCLUDES WORD(S)/ LETTER(S) /NUMBER(S)
Mark Literal Elements:
PRIMARY HEALTH

Goods And Services

For:
medical and healthcare services, namely, [general practice or family practice medical centers providing care to patients on an appointment and walk-in basis] and providing managed care services for additional care by specialists where necessary
First Use:
1996-01-29
International Classes:
042 - Primary Class
Class Status:
ACTIVE

Paycheck Protection Program

Date Approved:
2020-04-14
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Initial Approval Amount:
6375400
Current Approval Amount:
6375400
Race:
Unanswered
Ethnicity:
Unknown/NotStated
Gender:
Unanswered
Veteran:
Unanswered
Forgiveness Amount:
6447188.75

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Date of last update: 27 May 2025

Sources: Idaho Secretary of State