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ROCKY MOUNTAIN PHYSICIAN GROUP, LLC

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Company Details

Name: ROCKY MOUNTAIN PHYSICIAN GROUP, LLC
Jurisdiction: Idaho
Legal type: Limited Liability Company (D)
Status: Active-Existing
Date of registration: 17 Nov 2017 (8 years ago)
Financial Date End: 30 Nov 2025
Entity Number: 578563
Place of Formation: IDAHO
File Number: 578563
ZIP code: 83201
County: Bannock County
Principal Address: EMERGENCY DEPT 777 HOSPITAL WAY POCATELLO, ID 83201
Mailing Address: EMERGENCY DEPARTMENT 777 HOSPITAL WAY POCATELLO, ID 83201-5175

Agent

Name Role Address
DAN DALLON MD Agent EMERGENCY DEPT, 777 HOSPITAL WAY, POCATELLO, ID 83201

Manager

Name Role Address Appointed On
Daniel Dallon Manager 777 HOSPITAL WAY, POCATELLO, ID 83201 2021-10-10
Daniel Dallon MD Manager 777 HOSPITAL WAY, POCATELLO, ID 83201 2020-10-11

Unique Entity ID

Unique Entity ID:
C5DRER27N984
UEI Expiration Date:
2024-12-05

Business Information

Doing Business As:
ROCKY MOUNTAIN PHYSICIAN GROUP LLC
Activation Date:
2023-12-08
Initial Registration Date:
2023-12-06

National Provider Identifier

NPI Number:
1851808133

Authorized Person:

Name:
DANIEL DALLON
Role:
MANAGER
Phone:

Taxonomy:

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

Contacts:

Fax:
4805850051
Fax:
4804219700

Form 5500 Series

Employer Identification Number (EIN):
823920656
Plan Year:
2023
Number Of Participants:
22
Sponsors Telephone Number:
Plan Year:
2023
Number Of Participants:
16
Sponsors Telephone Number:
Plan Year:
2022
Number Of Participants:
21
Sponsors Telephone Number:
Plan Year:
2022
Number Of Participants:
15
Sponsors Telephone Number:
Plan Year:
2021
Number Of Participants:
16
Sponsors Telephone Number:

Filing

Filing Name Filing Number Filing date
Annual Report 0005919823 2024-10-03
Annual Report 0005420008 2023-10-03
Annual Report 0004991601 2022-11-12
Annual Report 0004442955 2021-10-10
Annual Report 0004029907 2020-10-11

USAspending Awards / Financial Assistance

Date:
2020-04-15
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:
124300.00
Total Face Value Of Loan:
124300.00

Paycheck Protection Program

Jobs Reported:
11
Initial Approval Amount:
$124,300
Date Approved:
2020-04-15
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Current Approval Amount:
$124,300
Race:
White
Ethnicity:
Not Hispanic or Latino
Gender:
Male Owned
Veteran:
Non-Veteran
Forgiveness Amount:
$125,863.12
Servicing Lender:
Glacier Bank
Use of Proceeds:
Payroll: $124,300

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Date of last update: 04 Jul 2025

Sources: Idaho Secretary of State