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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

A UEI is a government-provided number, like a tax ID number, that’s used to identify businesses eligible for federal grants, awards and contracts.

Note: In April 2022, the federal government replaced its old identifier of choice, the Data Universal Numbering System (DUNS) number, with a government-issued UEI. Now all the federal government’s Integrated Award Environment systems use UEI numbers instead of DUNS numbers. So any entity doing business with the federal government must register for a UEI.

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

Date Approved:
2020-04-15
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Initial Approval Amount:
124300
Current Approval Amount:
124300
Race:
White
Ethnicity:
Not Hispanic or Latino
Gender:
Male Owned
Veteran:
Non-Veteran
Forgiveness Amount:
125863.12

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Date of last update: 14 May 2025

Sources: Idaho Secretary of State