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TREASURE VALLEY FAMILY MEDICINE PLLC

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Company Details

Name: TREASURE VALLEY FAMILY MEDICINE PLLC
Jurisdiction: Idaho
Legal type: Limited Liability Company (D)
Status: Active-Existing
Date of registration: 14 May 2014 (11 years ago)
Financial Date End: 31 May 2026
Entity Number: 420809
Place of Formation: IDAHO
File Number: 420809
ZIP code: 83646
County: Ada County
Principal Address: 2428 N STOKESBERRY PL MERIDIAN, ID 83646
Mailing Address: 2428 N STOKESBERRY PL MERIDIAN, ID 83646-5035

Agent

Name Role Address
BRIAN CROWNOVER MD Agent 2428 N STOKESBERRY PL, MERIDIAN, ID 83646

Manager

Name Role Address Appointed On
BRIAN K CROWNOVER Manager 2428 N STOKESBERRY PL, MERIDIAN, ID 83646 2021-04-03

National Provider Identifier

NPI Number:
1841603768
Certification Date:
2023-09-12

Authorized Person:

Name:
DR. BRIAN KEITH CROWNOVER
Role:
OWNER/PRESIDENT/PHYSICIAN
Phone:

Taxonomy:

Selected Taxonomy:
261QP2300X - Primary Care Clinic/Center
Is Primary:
No
Selected Taxonomy:
261QP2300X - Primary Care Clinic/Center
Is Primary:
No
Selected Taxonomy:
207Q00000X - Family Medicine Physician
Is Primary:
Yes

Contacts:

Fax:
2088870033
Fax:
8555433086

Form 5500 Series

Employer Identification Number (EIN):
465672420
Plan Year:
2023
Number Of Participants:
13
Sponsors Telephone Number:
Plan Year:
2022
Number Of Participants:
11
Sponsors Telephone Number:
Plan Year:
2021
Number Of Participants:
8
Sponsors Telephone Number:
Plan Year:
2020
Number Of Participants:
10
Sponsors Telephone Number:
Plan Year:
2019
Number Of Participants:
8
Sponsors Telephone Number:

Filing

Filing Name Filing Number Filing date
Annual Report 0006179905 2025-04-01
Annual Report 0005666629 2024-04-03
Annual Report 0005179020 2023-04-03
Annual Report 0004683064 2022-04-03
Annual Report 0004227066 2021-04-03

Paycheck Protection Program

Jobs Reported:
8
Initial Approval Amount:
$117,700
Date Approved:
2020-04-07
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Current Approval Amount:
$117,700
Race:
Unanswered
Ethnicity:
Not Hispanic or Latino
Gender:
Male Owned
Veteran:
Veteran
Forgiveness Amount:
$118,570.66
Servicing Lender:
Idaho Central CU
Use of Proceeds:
Payroll: $88,275
Utilities: $14,712
Mortgage Interest: $14,713

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Date of last update: 21 Jul 2025

Sources: Idaho Secretary of State