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PEBBLE CREEK EMERGENCY PHYSICIANS, PLLC

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Company Details

Name: PEBBLE CREEK EMERGENCY PHYSICIANS, PLLC
Jurisdiction: Idaho
Legal type: Limited Liability Company (D)
Status: Active-Existing
Date of registration: 08 Dec 2015 (10 years ago)
Financial Date End: 31 Dec 2025
Entity Number: 483606
Place of Formation: IDAHO
File Number: 483606
ZIP code: 83713
County: Ada County
Principal Address: 12550 W EXPLORER DR STE 100 BOISE, ID 83713
Mailing Address: STE 500 20 BURTON HILLS BLVD NASHVILLE, TN 37215-6187

Agent

Name Role Address
CORPORATION SERVICE COMPANY Agent 1305 12TH AVE RD, NAMPA, ID 83686

Manager

Name Role Address Appointed On Resigned On
Joseph Gatewood MD Manager 1A BURTON HILLS BLVD, NASHVILLE, TN 37215-6187 2021-12-06 2023-12-07
JOSEPH GATWOOD, M.D. Manager 1A BURTON HILLS BLVD, NASHVILLE, TN 37215-6187 2020-12-07 2021-12-06
Joseph H. Gatewood MD Manager 1A BURTON HILLS BLVD, NASHVILLE, TN 37215-6187 2023-12-07 No data

National Provider Identifier

NPI Number:
1386019784

Authorized Person:

Name:
JOSEPH H GATEWOOD
Role:
PRESIDENT
Phone:

Taxonomy:

Selected Taxonomy:
207P00000X - Emergency Medicine Physician
Is Primary:
Yes

Contacts:

Filing

Filing Name Filing Number Filing date
Annual Report 0005990828 2024-11-21
Annual Report 0005504852 2023-12-07
Annual Report 0005041077 2022-12-29
Registered Agent Name/Address Change (mass change) 0004640185 2022-03-08
Annual Report 0004518781 2021-12-06

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Date of last update: 12 May 2025

Sources: Idaho Secretary of State