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IDAHO FALLS DERMATOLOGY, P.A.

IDAHO FALLS DERMATOLOGY, P.A.

Company Details

Name:	IDAHO FALLS DERMATOLOGY, P.A.
Jurisdiction:	Idaho
Legal type:	Professional Service Corporation (D)
Status:	Active-Good Standing
Date of registration:	19 Aug 1991 (34 years ago)
Financial Date End:	31 Aug 2025
Entity Number:	297710
Place of Formation:	IDAHO
File Number:	297710
ZIP code:	83404
County:	Bonneville County
Mailing Address:	STE 12A 2001 S WOODRUFF AVE IDAHO FALLS, ID 83404-6372

form 5500

Plan Name

Plan Year

EIN/PN

Received

Sponsor

Total number of participants

IDAHO FALLS DERMATOLOGY, P.A. PROFIT SHARING PLAN

2023

820445241

2024-09-26

IDAHO FALLS DERMATOLOGY, P.A.

11

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	1998-01-01
Business code	621111
Sponsor’s telephone number	2085228945
Plan sponsor’s address	2001 S. WOODRUFF AVE., STE. 12A, IDAHO FALLS, ID, 83404

IDAHO FALLS DERMATOLOGY, P.A. PROFIT SHARING PLAN

2022

820445241

2023-10-09

IDAHO FALLS DERMATOLOGY, P.A.

11

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	1998-01-01
Business code	621111
Sponsor’s telephone number	2085228945
Plan sponsor’s address	2001 S. WOODRUFF AVE., STE. 12A, IDAHO FALLS, ID, 83404

IDAHO FALLS DERMATOLOGY, P.A. PROFIT SHARING PLAN

2021

820445241

2022-10-17

IDAHO FALLS DERMATOLOGY, P.A.

10

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	1998-01-01
Business code	621111
Sponsor’s telephone number	2085228945
Plan sponsor’s address	2001 S. WOODRUFF AVE., STE. 12A, IDAHO FALLS, ID, 83404

IDAHO FALLS DERMATOLOGY, P.A. PROFIT SHARING PLAN

2020

820445241

2021-09-10

IDAHO FALLS DERMATOLOGY, P.A.

9

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	1998-01-01
Business code	621111
Sponsor’s telephone number	2085228945
Plan sponsor’s address	2001 S. WOODRUFF AVE., STE. 12A, IDAHO FALLS, ID, 83404

IDAHO FALLS DERMATOLOGY, P.A. PROFIT SHARING PLAN

2019

820445241

2020-10-08

IDAHO FALLS DERMATOLOGY, P.A.

7

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	1998-01-01
Business code	621111
Sponsor’s telephone number	2085228945
Plan sponsor’s address	2001 S. WOODRUFF AVE., STE. 12A, IDAHO FALLS, ID, 83404

IDAHO FALLS DERMATOLOGY, P.A. PROFIT SHARING PLAN

2018

820445241

2019-10-07

IDAHO FALLS DERMATOLOGY, P.A.

6

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	1998-01-01
Business code	621111
Sponsor’s telephone number	2085228945
Plan sponsor’s address	2001 S. WOODRUFF AVE., STE. 12A, IDAHO FALLS, ID, 83404

IDAHO FALLS DERMATOLOGY, P.A. PROFIT SHARING PLAN

2017

820445241

2018-06-14

IDAHO FALLS DERMATOLOGY, P.A.

6

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	1998-01-01
Business code	621111
Sponsor’s telephone number	2085228945
Plan sponsor’s address	2001 S. WOODRUFF AVE., STE. 12A, IDAHO FALLS, ID, 83404

IDAHO FALLS DERMATOLOGY, P.A. PROFIT SHARING PLAN

2016

820445241

2017-03-27

IDAHO FALLS DERMATOLOGY, P.A.

7

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	1998-01-01
Business code	621111
Sponsor’s telephone number	2085228945
Plan sponsor’s address	2001 S. WOODRUFF AVE., STE. 12A, IDAHO FALLS, ID, 83404

IDAHO FALLS DERMATOLOGY, P.A. PROFIT SHARING PLAN

2015

820445241

2016-03-15

IDAHO FALLS DERMATOLOGY, P.A.

10

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	1998-01-01
Business code	621111
Sponsor’s telephone number	2085228945
Plan sponsor’s address	2860 CHANNING WAY, SUITE 121, IDAHO FALLS, ID, 83404

IDAHO FALLS DERMATOLOGY, P.A. PROFIT SHARING PLAN

2014

820445241

2015-04-22

IDAHO FALLS DERMATOLOGY, P.A.

9

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	1998-01-01
Business code	621111
Sponsor’s telephone number	2085228945
Plan sponsor’s address	2860 CHANNING WAY, SUITE 122, IDAHO FALLS, ID, 83404

Agent

Name	Role	Address
PAUL BROOKE, M.D.	Agent	2001 S. WOODRUFF, STE 12A, IDAHO FALLS, ID 83404

President

Name	Role	Address	Appointed On	Resigned On
Paul Brooke MD	President	2001 S WOODRUFF, IDAHO FALLS, ID 83404	2023-07-11	No data
C Paul Brooke	President	2001 S WOODRUFF AVE, IDAHO FALLS, ID 83404	2020-07-07	2021-03-02

Secretary

Name	Role	Address	Appointed On
Margo Brooke	Secretary	6229 HIGHWAY 12 WEST, HELENA, MT 89601	2021-03-02

Filing

Filing Name	Filing Number	Filing date
Annual Report	0005796299	2024-07-03
Annual Report	0005315842	2023-07-11
Annual Report	0004805095	2022-07-05
Annual Report	0004336314	2021-07-07
Annual Report Amendment	0004187437	2021-03-02
Annual Report	0003933498	2020-07-07
Annual Report	0003584521	2019-07-31
Annual Report	0002215711	2018-06-20
Annual Report	0002215710	2017-08-06
Annual Report	0002215709	2016-08-30
Statement of Change of Business Mailing Address	0002215708	2016-05-23
Annual Report	0002215707	2015-06-28
Annual Report	0002215706	2014-06-08
Legacy Amendment	0002215705	2014-05-12
Annual Report	0002215704	2013-06-16
Annual Report	0002215703	2012-06-24
Annual Report	0002215696	2011-06-13
Annual Report	0002215695	2010-06-09
Annual Report	0002215694	2009-06-10
Annual Report	0002215700	2008-07-02
Annual Report	0002215699	2007-06-13
Annual Report	0002215687	2006-06-12
Annual Report	0002215686	2005-06-14
Legacy Amendment	0002215681	2005-01-12
Annual Report	0002215685	2004-06-16
Annual Report	0002215684	2003-06-12
Annual Report	0002215680	2002-08-28
Annual Report	0002215702	2001-08-23
Annual Report	0002215701	2000-08-03
Annual Report	0002215693	1999-07-21
Annual Report	0002215683	1998-08-13
Annual Report	0002215692	1997-07-30
Annual Report	0002215691	1996-07-19
Annual Report	0002215690	1995-08-04
Annual Report	0002215689	1994-10-31
Annual Report	0002215688	1993-09-07
Annual Report	0002215682	1992-10-16
Initial Filing	0000297710	1991-08-19

Paycheck Protection Program

Loan Number

Loan Funded Date

SBA Origination Office Code

Loan Delivery Method

Borrower Street Address

1628927304

2020-04-28

1087

PPP

2001 S WOODRUFF AVE STE 12A, IDAHO FALLS, ID, 83404-6372

Loan Status Date	2021-04-08
Loan Status	Paid in Full
Loan Maturity in Months	24
SBA Guaranty Percentage	100
Loan Approval Amount (at origination)	59800
Loan Approval Amount (current)	59800
Undisbursed Amount	0
Franchise Name	-
Lender Location ID	20158
Servicing Lender Name	Bank of Idaho
Servicing Lender Address	399 N Capital Ave, IDAHO FALLS, ID, 83402-3632
Rural or Urban Indicator	U
Hubzone	N
LMI	N
Business Age Description	Existing or more than 2 years old
Project Address	IDAHO FALLS, BONNEVILLE, ID, 83404-6372
Project Congressional District	ID-02
Number of Employees	9
NAICS code	621111
Borrower Race	White
Borrower Ethnicity	Unknown/NotStated
Business Type	Corporation
Originating Lender ID	20158
Originating Lender Name	Bank of Idaho
Originating Lender Address	IDAHO FALLS, ID
Gender	Male Owned
Veteran	Veteran
Forgiveness Amount	60312.81
Forgiveness Paid Date	2021-03-16

Date of last update: 04 Apr 2025

Sources: Idaho Secretary of State