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ASHLEY A. DAVIS, M.D., P.C.

Company Details

Name: ASHLEY A. DAVIS, M.D., P.C.
Jurisdiction: Idaho
Legal type: Professional Service Corporation (D)
Status: Active-Good Standing
Date of registration: 16 Sep 2003 (21 years ago)
Financial Date End: 30 Sep 2025
Entity Number: 458932
Place of Formation: IDAHO
File Number: 458932
ZIP code: 83702
County: Ada County
Mailing Address: STE 204 222 N 2ND ST BOISE, ID 83702-6130

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
DAVIS FAMILY MEDICINE 401(K) PROFIT SHARING PLAN 2020 680569751 2021-07-30 ASHLEY A. DAVIS, M.D., P.C. 10
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-01-01
Business code 621111
Sponsor’s telephone number 2084299100
Plan sponsor’s address 222 N 2ND ST, SUITE 204, BOISE, ID, 83702

Plan administrator’s name and address

Administrator’s EIN 842925395
Plan administrator’s name 401GO, INC.
Plan administrator’s address 8427 OLD BINGHAM HIGHWAY, SUITE A, WEST JORDAN, UT, 84088
Administrator’s telephone number 8012142125

Signature of

Role Plan administrator
Date 2021-07-29
Name of individual signing FIDUCIARY ASSISTANCE
Valid signature Filed with authorized/valid electronic signature
DAVIS FAMILY MEDICINE 401(K) PROFIT SHARING PLAN 2019 680569751 2020-06-24 ASHLEY A. DAVIS, M.D., P.C. 11
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-01-01
Business code 621111
Sponsor’s telephone number 2084299100
Plan sponsor’s address 222 NORTH SECOND STREET, SUITE 204, BOISE, ID, 83702
DAVIS FAMILY MEDICINE 401(K) PROFIT SHARING PLAN 2018 680569751 2019-04-26 ASHLEY A. DAVIS, M.D., P.C. 9
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-01-01
Business code 621111
Sponsor’s telephone number 2084299100
Plan sponsor’s address 222 NORTH SECOND STREET, SUITE 204, BOISE, ID, 83702

Signature of

Role Plan administrator
Date 2019-04-26
Name of individual signing ASHLEY A. DAVIS
Valid signature Filed with authorized/valid electronic signature
DAVIS FAMILY MEDICINE 401(K) PROFIT SHARING PLAN 2017 680569751 2018-04-02 ASHLEY A. DAVIS, M.D., P.C. 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-01-01
Business code 621111
Sponsor’s telephone number 2084299100
Plan sponsor’s address 222 NORTH SECOND STREET, SUITE 204, BOISE, ID, 83702

Signature of

Role Plan administrator
Date 2018-04-02
Name of individual signing ASHLEY A. DAVIS
Valid signature Filed with authorized/valid electronic signature
DAVIS FAMILY MEDICINE 401(K) PROFIT SHARING PLAN 2016 680569751 2017-04-05 ASHLEY A. DAVIS, M.D., P.C. 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-01-01
Business code 621111
Sponsor’s telephone number 2084299100
Plan sponsor’s address 222 NORTH SECOND STREET, SUITE 204, BOISE, ID, 83702

Signature of

Role Plan administrator
Date 2017-04-05
Name of individual signing ASHLEY A. DAVIS
Valid signature Filed with authorized/valid electronic signature
DAVIS FAMILY MEDICINE 401(K) PROFIT SHARING PLAN 2015 680569751 2016-05-12 ASHLEY A. DAVIS, M.D., P.C. 9
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-01-01
Business code 621111
Sponsor’s telephone number 2084299100
Plan sponsor’s address 222 NORTH SECOND STREET, SUITE 204, BOISE, ID, 83702

Signature of

Role Plan administrator
Date 2016-05-12
Name of individual signing ASHLEY A. DAVIS
Valid signature Filed with authorized/valid electronic signature
DAVIS FAMILY MEDICINE 401(K) PROFIT SHARING PLAN 2014 680569751 2015-04-06 ASHLEY A. DAVIS, M.D., P.C. 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-01-01
Business code 621111
Sponsor’s telephone number 2084299100
Plan sponsor’s address 222 NORTH SECOND STREET, SUITE 204, BOISE, ID, 83702

Signature of

Role Plan administrator
Date 2015-04-06
Name of individual signing ASHLEY A. DAVIS
Valid signature Filed with authorized/valid electronic signature
DAVIS FAMILY MEDICINE 401(K) PROFIT SHARING PLAN 2013 680569751 2014-05-27 ASHLEY A. DAVIS, M.D., P.C. 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-01-01
Business code 621111
Sponsor’s telephone number 2084299100
Plan sponsor’s address 222 NORTH SECOND STREET, SUITE 204, BOISE, ID, 83702

Signature of

Role Plan administrator
Date 2014-05-27
Name of individual signing ASHLEY A. DAVIS
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
ASHLEY A DAVIS Agent 222 N 2ND ST STE 204, BOISE, ID 83702

President

Name Role Address Appointed On
Ashley A Davis President 222 N 2ND ST, BOISE, ID 83702 2021-08-03
Ashley A Davis MD President 222 N 2ND ST, BOISE, ID 83702 2020-08-03

Treasurer

Name Role Address Appointed On
Christoph A Walser Treasurer 1606 N 20TH, BOISE, ID 83702 2023-09-08

Filing

Filing Name Filing Number Filing date
Annual Report 0005898792 2024-09-12
Annual Report 0005391997 2023-09-08
Annual Report 0004842437 2022-08-03
Annual Report 0004368112 2021-08-03
Annual Report 0003955633 2020-08-03
Annual Report 0003587561 2019-08-03
Annual Report 0002934955 2018-08-18
Annual Report 0002934954 2017-08-01
Annual Report 0002934953 2016-08-31
Annual Report 0002934951 2015-08-10

Date of last update: 21 Dec 2024

Sources: Idaho Secretary of State