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ALPINE EAR NOSE & THROAT, P.C.

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Company Details

Name: ALPINE EAR NOSE & THROAT, P.C.
Jurisdiction: Idaho
Legal type: Professional Service Corporation (D)
Status: Active-Good Standing
Date of registration: 06 Mar 2002 (23 years ago)
Financial Date End: 31 Mar 2026
Date dissolved: 12 Jun 2024
Entity Number: 435238
Place of Formation: IDAHO
File Number: 435238
ZIP code: 83404
County: Bonneville County
Mailing Address: STE B 2065 E 17TH ST IDAHO FALLS, ID 83404-8042

Agent

Name Role Address
MARK CAPENER MD Agent 2065 E 17TH ST, SUITE B, IDAHO FALLS, ID 83404

Secretary

Name Role Address Appointed On Resigned On
Sally Capener Secretary 2065 E 17TH ST, IDAHO FALLS, ID 83404-8042 2021-02-08 2023-02-09

President

Name Role Address Appointed On
MARK Capener President 2065 E. 17TH STREET, SUITE B, IDAHO FALLS, ID 83406 2025-03-03

National Provider Identifier

NPI Number:
1306944772

Authorized Person:

Name:
DR. MARK LEE CAPENER
Role:
PHYSICIAN
Phone:

Taxonomy:

Selected Taxonomy:
207YX0905X - Otolaryngology/Facial Plastic Surgery Physician
Is Primary:
Yes

Contacts:

Fax:
2085241088

Form 5500 Series

Employer Identification Number (EIN):
460468886
Plan Year:
2015
Number Of Participants:
5
Sponsors Telephone Number:
Plan Year:
2015
Number Of Participants:
6
Sponsors Telephone Number:
Plan Year:
2014
Number Of Participants:
6
Sponsors Telephone Number:
Plan Year:
2013
Number Of Participants:
4
Sponsors Telephone Number:
Plan Year:
2011
Number Of Participants:
4

Filing

Filing Name Filing Number Filing date
Annual Report 0006138331 2025-03-03
Application for Reinstatement 0005934975 2024-10-09
Dissolution/Revocation - Administrative 0005777478 2024-06-12
Annual Report 0005106453 2023-02-09
Annual Report 0004652749 2022-03-10

Paycheck Protection Program

Jobs Reported:
6
Initial Approval Amount:
$53,000
Date Approved:
2020-04-14
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Current Approval Amount:
$52,900
Race:
Unanswered
Ethnicity:
Unknown/NotStated
Gender:
Unanswered
Veteran:
Unanswered
Forgiveness Amount:
$53,352.19
Servicing Lender:
Bank of Idaho
Use of Proceeds:
Payroll: $52,900

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Date of last update: 08 Aug 2025

Sources: Idaho Secretary of State