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ORTHOPAEDIC SPECIALISTS OF IDAHO, PLLC

Company Details

Name: ORTHOPAEDIC SPECIALISTS OF IDAHO, PLLC
Jurisdiction: Idaho
Legal type: Limited Liability Company (D)
Status: Inactive-Dissolved (Administrative)
Date of registration: 07 Sep 2012 (12 years ago)
Financial Date End: 30 Sep 2022
Date dissolved: 08 Dec 2022
Entity Number: 359937
Place of Formation: IDAHO
File Number: 359937
ZIP code: 83713
County: Ada County
Principal Address: 6225 N MEEKER PL STE 205 BOISE, ID 83713
Mailing Address: STE 205 6225 N MEEKER PL BOISE, ID 83713-1590

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
ORTHOPAEDIC SPECIALISTS OF IDAHO, PLLC CASH BALANCE PLAN AND TRUST 2020 461131395 2021-07-25 ORTHOPAEDIC SPECIALISTS OF IDAHO, PLLC 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2012-10-01
Business code 621111
Sponsor’s telephone number 2083755150
Plan sponsor’s address 101 S. CAPITOL BLVD, 10TH FLOOR, BOISE, ID, 83702

Signature of

Role Plan administrator
Date 2021-07-25
Name of individual signing MICHAEL SHEVLIN
Valid signature Filed with authorized/valid electronic signature
ORTHOPAEDIC SPECIALISTS OF IDAHO, PLLC 401(K) PLAN 2020 461131395 2021-07-25 ORTHOPAEDIC SPECIALISTS OF IDAHO, PLLC 4
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2013-01-02
Business code 621111
Sponsor’s telephone number 2083755150
Plan sponsor’s address 101 S. CAPITOL BLVD, 10TH FLOOR, BOISE, ID, 83702

Signature of

Role Plan administrator
Date 2021-07-25
Name of individual signing MICHAEL SHEVLIN
Valid signature Filed with authorized/valid electronic signature
ORTHOPAEDIC SPECIALISTS OF IDAHO, PLLC 401(K) PLAN 2019 461131395 2020-10-06 ORTHOPAEDIC SPECIALISTS OF IDAHO, PLLC 5
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2013-01-02
Business code 621111
Sponsor’s telephone number 2083755150
Plan sponsor’s address 101 S. CAPITOL BLVD, 10TH FLOOR, BOISE, ID, 83702

Signature of

Role Plan administrator
Date 2020-10-06
Name of individual signing MICHAEL SHEVLIN
Valid signature Filed with authorized/valid electronic signature
ORTHOPAEDIC SPECIALISTS OF IDAHO, PLLC CASH BALANCE PLAN AND TRUST 2019 461131395 2020-10-06 ORTHOPAEDIC SPECIALISTS OF IDAHO, PLLC 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2012-10-01
Business code 621111
Sponsor’s telephone number 2083755150
Plan sponsor’s address 101 S. CAPITOL BLVD, 10TH FLOOR, BOISE, ID, 83702

Signature of

Role Plan administrator
Date 2020-10-06
Name of individual signing MICHAEL SHEVLIN
Valid signature Filed with authorized/valid electronic signature
ORTHOPAEDIC SPECIALISTS OF IDAHO, PLLC CASH BALANCE PLAN AND TRUST 2018 461131395 2019-10-12 ORTHOPAEDIC SPECIALISTS OF IDAHO, PLLC 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2012-10-01
Business code 621111
Sponsor’s telephone number 2083755150
Plan sponsor’s address 101 S. CAPITOL BLVD, 10TH FLOOR, BOISE, ID, 83702

Signature of

Role Plan administrator
Date 2019-10-12
Name of individual signing MICHAEL SHEVLIN
Valid signature Filed with authorized/valid electronic signature
ORTHOPAEDIC SPECIALISTS OF IDAHO, PLLC 401(K) PLAN 2018 461131395 2019-10-12 ORTHOPAEDIC SPECIALISTS OF IDAHO, PLLC 5
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2013-01-02
Business code 621111
Sponsor’s telephone number 2083755150
Plan sponsor’s address 101 S. CAPITOL BLVD, 10TH FLOOR, BOISE, ID, 83702

Signature of

Role Plan administrator
Date 2019-10-12
Name of individual signing MICHAEL SHEVLIN
Valid signature Filed with authorized/valid electronic signature
ORTHOPAEDIC SPECIALISTS OF IDAHO, PLLC CASH BALANCE PLAN AND TRUST 2017 461131395 2018-06-05 ORTHOPAEDIC SPECIALISTS OF IDAHO, PLLC 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2012-10-01
Business code 621111
Sponsor’s telephone number 2083755150
Plan sponsor’s address 101 S. CAPITOL BLVD, 10TH FLOOR, BOISE, ID, 83702

Signature of

Role Plan administrator
Date 2018-06-05
Name of individual signing KEITH HOLLEY
Valid signature Filed with authorized/valid electronic signature
ORTHOPAEDIC SPECIALISTS OF IDAHO, PLLC 401(K) PLAN 2017 461131395 2018-06-05 ORTHOPAEDIC SPECIALISTS OF IDAHO, PLLC 5
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2013-01-02
Business code 621111
Sponsor’s telephone number 2083755150
Plan sponsor’s address 101 S. CAPITOL BLVD, 10TH FLOOR, BOISE, ID, 83702

Signature of

Role Plan administrator
Date 2018-06-05
Name of individual signing KEITH HOLLEY
Valid signature Filed with authorized/valid electronic signature
ORTHOPAEDIC SPECIALISTS OF IDAHO, PLLC CASH BALANCE PLAN AND TRUST 2016 461131395 2017-10-11 ORTHOPAEDIC SPECIALISTS OF IDAHO, PLLC 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2012-10-01
Business code 621111
Sponsor’s telephone number 2083755150
Plan sponsor’s address 101 S. CAPITOL BLVD, 10TH FLOOR, BOISE, ID, 83702

Signature of

Role Plan administrator
Date 2017-10-11
Name of individual signing KEITH HOLLEY
Valid signature Filed with authorized/valid electronic signature
ORTHOPAEDIC SPECIALISTS OF IDAHO, PLLC 401(K) PLAN 2016 461131395 2017-06-16 ORTHOPAEDIC SPECIALISTS OF IDAHO, PLLC 5
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2013-01-02
Business code 621111
Sponsor’s telephone number 2083755150
Plan sponsor’s address 101 S. CAPITOL BLVD, 10TH FLOOR, BOISE, ID, 83702

Signature of

Role Plan administrator
Date 2017-06-16
Name of individual signing KEITH HOLLEY
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
BRYAN PALFREYMAN Agent 6225 N MEEKER PL STE 205, BOISE, ID 83713

Member

Name Role Address Appointed On
Miers Johnson Member 4424 E FLAMINGO AVE, NAMPA, ID 83687 2020-08-06

Filing

Filing Name Filing Number Filing date
Dissolution/Revocation - Administrative 0005019054 2022-12-08
Annual Report 0004450971 2021-10-19
Annual Report 0003961279 2020-08-06
Annual Report 0003614989 2019-09-04
Annual Report 0002538599 2018-07-30
Annual Report 0002538598 2017-07-31
Statement of Change of Business Mailing Address 0002538600 2017-02-01
Change of Registered Office/Agent/Both (by Entity) 0002538597 2017-01-30
Annual Report 0002538596 2016-08-27
Annual Report 0002538595 2015-07-20

Date of last update: 14 Dec 2024

Sources: Idaho Secretary of State