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Northwest Physicians and Surgeons PLLC

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Company Details

Name: Northwest Physicians and Surgeons PLLC
Jurisdiction: Idaho
Legal type: Limited Liability Company (D)
Status: Active-Existing
Date of registration: 08 Sep 2021 (4 years ago)
Financial Date End: 30 Sep 2025
Entity Number: 4410600
Place of Formation: IDAHO
File Number: 780856
ZIP code: 83814
County: Kootenai County
Principal Address: CORY JOHNSON 301 850 W. IRONWOOD DR. COEUR D'ALENE, ID 83814
Mailing Address: CORY JOHNSON STE 301 850 W IRONWOOD DR COEUR D ALENE, ID 83814-4903

Agent

Name Role Address
CORY JOHNSON Agent 5661 W GUMWOOD CIR, POST FALLS, ID 83854

Manager

Name Role Address Appointed On
Cory Johnson Manager 850 W. IRONWOOD DR, COEUR D'ALENE, ID 83814 2022-08-16

National Provider Identifier

NPI Number:
1023780376
Certification Date:
2021-10-04

Authorized Person:

Name:
DR. CORY AVERILL JOHNSON
Role:
OWNER/PROVIDER
Phone:

Taxonomy:

Selected Taxonomy:
213ES0103X - Foot & Ankle Surgery Podiatrist
Is Primary:
Yes

Contacts:

Fax:
2087651041

Filing

Filing Name Filing Number Filing date
Annual Report 0005928906 2024-10-04
Amendment to Certificate 0005757071 2024-06-03
Annual Report 0005355220 2023-08-07
Annual Report 0004862557 2022-08-16
Initial Filing 0004410600 2021-09-08

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Date of last update: 16 Jun 2025

Sources: Idaho Secretary of State