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ELLIS PHYSICAL THERAPY, P.A.

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Company Details

Name: ELLIS PHYSICAL THERAPY, P.A.
Jurisdiction: Idaho
Legal type: Professional Service Corporation (D)
Status: Active-Good Standing
Date of registration: 30 Jul 1993 (32 years ago)
Financial Date End: 31 Jul 2026
Entity Number: 317881
Place of Formation: IDAHO
File Number: 317881
ZIP code: 83406
County: Bonneville County
Mailing Address: JAY T ELLIS 2195 MIDWAY AVE AMMON, ID 83406-6766

Agent

Name Role Address
JAY T ELLIS Agent 2195 MIDWAY DRIVE, JAY T ELLIS, AMMON, ID 83406-7666

President

Name Role Address Appointed On
JAY T ELLIS President 2195 MIDWAY DR, , 2021-06-03

National Provider Identifier

NPI Number:
1518203249

Authorized Person:

Name:
TERRI L LARSEN
Role:
OFFICE MANAGER
Phone:

Taxonomy:

Selected Taxonomy:
225100000X - Physical Therapist
Is Primary:
Yes

Contacts:

Fax:
2085230436

Form 5500 Series

Employer Identification Number (EIN):
820463153
Plan Year:
2011
Number Of Participants:
10
Sponsors Telephone Number:
Plan Year:
2010
Number Of Participants:
14
Sponsors Telephone Number:
Plan Year:
2009
Number Of Participants:
12
Sponsors Telephone Number:

Filing

Filing Name Filing Number Filing date
Annual Report 0006337564 2025-07-03
Annual Report 0005759655 2024-06-04
Annual Report 0005292561 2023-06-25
Annual Report 0004768221 2022-06-03
Annual Report 0004302912 2021-06-03

USAspending Awards / Financial Assistance

Date:
2020-04-28
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:
93900.00
Total Face Value Of Loan:
93900.00

Paycheck Protection Program

Jobs Reported:
12
Initial Approval Amount:
$93,900
Date Approved:
2020-04-28
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Current Approval Amount:
$93,900
Race:
Unanswered
Ethnicity:
Not Hispanic or Latino
Gender:
Male Owned
Veteran:
Non-Veteran
Forgiveness Amount:
$94,715.52
Servicing Lender:
D. L. Evans Bank
Use of Proceeds:
Payroll: $70,425
Utilities: $11,737.5
Mortgage Interest: $11,737.5

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Date of last update: 05 Aug 2025

Sources: Idaho Secretary of State