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  5. FAMILY PRACTICE GROUP, P.A.

FAMILY PRACTICE GROUP, P.A.

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Company Details

Name: FAMILY PRACTICE GROUP, P.A.
Jurisdiction: Idaho
Legal type: Professional Service Corporation (D)
Status: Active-Good Standing
Date of registration: 10 Feb 1989 (37 years ago)
Financial Date End: 28 Feb 2026
Entity Number: 275609
Place of Formation: IDAHO
File Number: 275609
ZIP code: 83201
County: Bannock County
Mailing Address: SHELLY STRANSKI STE B 1951 BENCH RD POCATELLO, ID 83201-2073

President

Name Role Address Appointed On Resigned On
Blaine Olsen President 1951 BENCH RD., SUITE B, POCATELLO, ID 83201 2021-01-04 2023-03-09
Travis Nielsen President 1951 BENCH RD., POCATELLO, ID 83201 2023-03-09 No data

Agent

Name Role Address
Travis Nielsen Agent 1951 BENCH RD, STE B, POCATELLO, ID 83201-2073

Unique Entity ID

CAGE Code:
7NR80
UEI Expiration Date:
2018-06-14

Business Information

Doing Business As:
BAKER, MICHAEL S MD
Activation Date:
2017-06-14
Initial Registration Date:
2016-07-11

Commercial and government entity program

CAGE number:
7NR80
Status:
Obsolete
Type:
Non-Manufacturer
CAGE Update Date:
2022-06-15
CAGE Expiration:
2022-06-14

Contact Information

POC:
SHELLY STRANSKI

National Provider Identifier

NPI Number:
1912723214
Certification Date:
2024-11-26
Link:
View on NPI website

Authorized Person:

Name:
JANETTE ROPICKY
Role:
CERTIFIED CODER
Phone:
2082381000

Taxonomy:

Selected Taxonomy:
261QR0404X - Cardiac Rehabilitation Clinic/Center
Is Primary:
Yes

Contacts:

Phone:
+1 208-238-1000
Fax:
2082380009

Form 5500 Series

Employer Identification Number (EIN):
820437409
Plan Year:
2023
Number Of Participants:
31
Sponsors Telephone Number:
2082357218
File:
View File
Plan Year:
2022
Number Of Participants:
31
Sponsors Telephone Number:
2082357218
File:
View File
Plan Year:
2021
Number Of Participants:
37
Sponsors Telephone Number:
2082357218
File:
View File
Plan Year:
2020
Number Of Participants:
40
Sponsors Telephone Number:
2082357218
File:
View File
Plan Year:
2019
Number Of Participants:
35
Sponsors Telephone Number:
2082357218
File:
View File

Filing

Filing Name Filing Number Filing date
Annual Report 0006089590 2025-02-03
Annual Report 0005584977 2024-02-05
Annual Report 0005150621 2023-03-09
Annual Report 0004550558 2022-01-03
Annual Report 0004115053 2021-01-04

USAspending Awards / Financial Assistance

Date:
2020-04-15
Link:
View on USAspending
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:
-100.00
Total Face Value Of Loan:
315900.00
Date:
2020-04-15
Link:
View on USAspending
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:
-100.00
Total Face Value Of Loan:
315900.00

Paycheck Protection Program

Jobs Reported:
38
Initial Approval Amount:
$316,000
Date Approved:
2020-04-09
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Current Approval Amount:
$315,900
Race:
Unanswered
Ethnicity:
Unknown/NotStated
Gender:
Unanswered
Veteran:
Unanswered
Forgiveness Amount:
$317,683.78
Servicing Lender:
Bank of Idaho
Use of Proceeds:
Payroll: $315,900

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Date of last update: 04 Aug 2025

Sources: Idaho Secretary of State

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