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EAST IDAHO ORTHOPAEDICS PLLC

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Company Details

Name: EAST IDAHO ORTHOPAEDICS PLLC
Jurisdiction: Idaho
Legal type: Limited Liability Company (D)
Status: Active-Existing
Date of registration: 14 Apr 2016 (9 years ago)
Financial Date End: 30 Apr 2026
Entity Number: 501081
Place of Formation: IDAHO
File Number: 501081
ZIP code: 83404
County: Bonneville County
Principal Address: 3405 MERLIN DR IDAHO FALLS, ID 83404
Mailing Address: 2210 CORONADO ST IDAHO FALLS, ID 83404-7552

Agent

Name Role Address
JARED W ALLEN Agent BEARD ST CLAIR GAFFNEY, PA, 955 PIER VIEW DRIVE, IDAHO FALLS, ID 83402

Manager

Name Role Address Appointed On Resigned On
Alexis Bergeson Manager 3405 MERLIN DR, IDAHO FALLS, ID 83404 2021-03-11 2024-03-05
Amund Evans Manager 2210 CORONADO ST, IDAHO FALLS, ID 83404 2024-03-05 No data

National Provider Identifier

NPI Number:
1295189918

Authorized Person:

Name:
MRS. ALEXIS L BERGESON
Role:
PRACTICE MANAGER
Phone:

Taxonomy:

Selected Taxonomy:
207X00000X - Orthopaedic Surgery Physician
Is Primary:
No
Selected Taxonomy:
207XX0005X - Sports Medicine (Orthopaedic Surgery) Physician
Is Primary:
No
Selected Taxonomy:
207X00000X - Orthopaedic Surgery Physician
Is Primary:
Yes

Contacts:

Fax:
2085226019

Form 5500 Series

Employer Identification Number (EIN):
812293923
Plan Year:
2023
Number Of Participants:
17
Sponsors Telephone Number:
Plan Year:
2023
Number Of Participants:
15
Sponsors Telephone Number:
Plan Year:
2022
Number Of Participants:
19
Sponsors Telephone Number:
Plan Year:
2022
Number Of Participants:
17
Sponsors Telephone Number:
Plan Year:
2021
Number Of Participants:
18
Sponsors Telephone Number:

Filing

Filing Name Filing Number Filing date
Annual Report 0006138558 2025-03-03
Annual Report 0005635570 2024-03-05
Annual Report 0005139645 2023-03-06
Annual Report 0004630162 2022-03-03
Statement of Change of Business Mailing Address 0004477370 2021-11-03

USAspending Awards / Financial Assistance

Date:
2020-04-29
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:
123370.00
Total Face Value Of Loan:
123370.00

Paycheck Protection Program

Date Approved:
2020-04-28
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Initial Approval Amount:
123370
Current Approval Amount:
123370
Race:
Unanswered
Ethnicity:
Unknown/NotStated
Gender:
Unanswered
Veteran:
Unanswered
Forgiveness Amount:
124600.27

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Date of last update: 06 Jun 2025

Sources: Idaho Secretary of State