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IDAHO OCCUPATIONAL MEDICINE GROUP, PLLC

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Company Details

Name: IDAHO OCCUPATIONAL MEDICINE GROUP, PLLC
Jurisdiction: Idaho
Legal type: Limited Liability Company (D)
Status: Active-Existing
Date of registration: 14 Feb 2008 (17 years ago)
Financial Date End: 28 Feb 2026
Entity Number: 224544
Place of Formation: IDAHO
File Number: 224544
ZIP code: 83814
County: Kootenai County
Principal Address: 3318 N GRAND MILL LN COEUR D ALENE, ID 83814-5689
Mailing Address: 1839 N GOVERNMENT WAY COEUR D ALENE, ID 83814-3454

Agent

Name Role Address
MICHAEL ALAN LUDWIG Agent 1839 N. GOVERNMENT WAY, COEUR D’ALENE, ID 83814

Manager

Name Role Address Appointed On
Idaho Occupational Medicine Group Manager 1839 N GOVERNMENT WAY, COEUR D’ALENE, ID 83815 2021-01-04

Unique Entity ID

Unique Entity ID:
LRBDTNA76SQ4
UEI Expiration Date:
2025-11-11

Business Information

Activation Date:
2024-11-20
Initial Registration Date:
2022-12-13

National Provider Identifier

NPI Number:
1366908949
Certification Date:
2021-08-25

Authorized Person:

Name:
DR. MICHAEL ALAN LUDWIG
Role:
OWNER
Phone:

Taxonomy:

Selected Taxonomy:
208100000X - Physical Medicine & Rehabilitation Physician
Is Primary:
Yes

Contacts:

Fax:
2082923177

Filing

Filing Name Filing Number Filing date
Annual Report 0006051528 2025-01-06
Annual Report 0005552762 2024-01-09
Annual Report 0005103599 2023-02-08
Annual Report 0004600958 2022-02-08
Statement of Change of Business Mailing Address 0004389583 2021-08-20

USAspending Awards / Financial Assistance

Date:
2021-02-16
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:
71120.00
Total Face Value Of Loan:
71120.00
Date:
2020-04-15
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:
98471.47
Total Face Value Of Loan:
98471.47

Paycheck Protection Program

Jobs Reported:
4
Initial Approval Amount:
$98,471.47
Date Approved:
2020-04-15
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Current Approval Amount:
$98,471.47
Race:
White
Ethnicity:
Not Hispanic or Latino
Gender:
Male Owned
Veteran:
Non-Veteran
Forgiveness Amount:
$99,167.51
Servicing Lender:
Glacier Bank
Use of Proceeds:
Payroll: $98,471.47
Jobs Reported:
5
Initial Approval Amount:
$71,120
Date Approved:
2021-02-16
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Current Approval Amount:
$71,120
Race:
White
Ethnicity:
Not Hispanic or Latino
Gender:
Male Owned
Veteran:
Non-Veteran
Forgiveness Amount:
$71,402.53
Servicing Lender:
Glacier Bank
Use of Proceeds:
Payroll: $71,118
Utilities: $1

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Date of last update: 17 Jul 2025

Sources: Idaho Secretary of State