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LEWISTON ORTHOPAEDIC ASSOCIATES, P.A.

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Company Details

Name: LEWISTON ORTHOPAEDIC ASSOCIATES, P.A.
Jurisdiction: Idaho
Legal type: Professional Service Corporation (D)
Status: Inactive-Dissolved (Administrative)
Date of registration: 27 Dec 1972 (53 years ago)
Financial Date End: 31 Dec 2021
Date dissolved: 23 Mar 2022
Entity Number: 151697
Place of Formation: IDAHO
File Number: 151697
ZIP code: 83501
County: Nez Perce County
Mailing Address: 320 WARNER DR LEWISTON, ID 83501-4441

Agent

Name Role Address
CINDY L KEENE Agent 320 WARNER DRIVE, LEWISTON, ID 83501

Director

Name Role Address Appointed On
Timothy Flock Director 320 WARNER DR, LEWISTON, ID 83501 2020-11-03

National Provider Identifier

NPI Number:
1215095252

Authorized Person:

Name:
MRS. CINDY L KEENE
Role:
CEO
Phone:

Taxonomy:

Selected Taxonomy:
261QM2500X - Medical Specialty Clinic/Center
Is Primary:
No
Selected Taxonomy:
261QM1300X - Multi-Specialty Clinic/Center
Is Primary:
No
Selected Taxonomy:
204C00000X - Sports Medicine (Neuromusculoskeletal Medicine) Physician
Is Primary:
Yes

Contacts:

Fax:
2087468741

Form 5500 Series

Employer Identification Number (EIN):
820303594
Plan Year:
2017
Number Of Participants:
88
Sponsors Telephone Number:
Plan Year:
2016
Number Of Participants:
75
Sponsors Telephone Number:
Plan Year:
2015
Number Of Participants:
73
Sponsors Telephone Number:
Plan Year:
2014
Number Of Participants:
71
Sponsors Telephone Number:
Plan Year:
2013
Number Of Participants:
70
Sponsors Telephone Number:

Filing

Filing Name Filing Number Filing date
Dissolution/Revocation - Administrative 0004669425 2022-03-23
Annual Report 0004050682 2020-11-03
Annual Report 0003660691 2019-11-01
Annual Report 0003366043 2018-12-07
Annual Report 0001510790 2017-10-30

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Date of last update: 01 Aug 2025

Sources: Idaho Secretary of State