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GEM STATE RADIOLOGY, LLP

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Company Details

Name: GEM STATE RADIOLOGY, LLP
Jurisdiction: Idaho
Legal type: Limited Liability Partnership (D)
Status: Active-Existing
Date of registration: 20 Mar 1996 (29 years ago)
Financial Date End: 31 Mar 2026
Entity Number: 422
Place of Formation: IDAHO
File Number: 422
ZIP code: 83702
County: Ada County
Principal Address: 877 W MAIN ST STE 603 BOISE, ID 83702
Mailing Address: STE 603 877 W MAIN ST BOISE, ID 83702-6070

Agent

Name Role Address
John Jackson Agent 877 W MAIN STREET, 603, BOISE, ID 83702

Officer

Name Role Address Appointed On Resigned On
Ian Davey Officer 1673 S RIDGEPOINT PL, BOISE, ID 83712 2024-02-05 2024-02-05
Neil Davey Officer 2121 BLUESTEM LANE, BOISE, ID 83706 2021-02-05 No data
Benjamin Hom Officer 2879 W SUGARBERRY DR, EAGLE, ID 83616 2024-02-05 2024-02-05

Unique Entity ID

CAGE Code:
79LE5
UEI Expiration Date:
2019-03-26

Business Information

Activation Date:
2018-03-26
Initial Registration Date:
2014-08-15

Commercial and government entity program

CAGE number:
79LE5
Status:
Obsolete
Type:
Non-Manufacturer
CAGE Update Date:
2023-03-27
CAGE Expiration:
2023-03-26

Contact Information

POC:
KAREN NOYES

National Provider Identifier

NPI Number:
1124258611
Certification Date:
2023-10-31

Authorized Person:

Name:
MR. WAYNE BALDWIN
Role:
EXECUTIVE DIRECTOR
Phone:

Taxonomy:

Selected Taxonomy:
2085U0001X - Diagnostic Ultrasound Physician
Is Primary:
No
Selected Taxonomy:
2086S0129X - Vascular Surgery Physician
Is Primary:
Yes

Contacts:

Fax:
2083849023

Form 5500 Series

Employer Identification Number (EIN):
826041596
Plan Year:
2023
Number Of Participants:
1
Sponsors Telephone Number:

Filing

Filing Name Filing Number Filing date
Annual Report 0006091928 2025-02-03
Annual Report 0005585551 2024-02-05
Annual Report 0005106209 2023-02-09
Annual Report 0004593169 2022-02-03
Annual Report 0004166374 2021-02-05

USAspending Awards / Financial Assistance

Date:
2020-04-14
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:
-107127.00
Total Face Value Of Loan:
1427873.00

Paycheck Protection Program

Jobs Reported:
48
Initial Approval Amount:
$1,535,000
Date Approved:
2020-04-11
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Current Approval Amount:
$1,427,873
Race:
Unanswered
Ethnicity:
Unknown/NotStated
Gender:
Unanswered
Veteran:
Unanswered
Forgiveness Amount:
$1,443,481.8
Servicing Lender:
Idaho First Bank
Use of Proceeds:
Payroll: $1,427,873

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Date of last update: 25 Aug 2025

Sources: Idaho Secretary of State