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  5. INTERMOUNTAIN AMBULATORY ANESTHESIA PLLC

INTERMOUNTAIN AMBULATORY ANESTHESIA PLLC

Company Details

Name: INTERMOUNTAIN AMBULATORY ANESTHESIA PLLC
Jurisdiction: Idaho
Legal type: Limited Liability Company (D)
Status: Active-Existing
Date of registration: 19 Apr 2001 (24 years ago)
Financial Date End: 30 Apr 2026
Entity Number: 59396
Place of Formation: IDAHO
File Number: 59396
ZIP code: 83642
County: Ada County
Principal Address: IAA, KIRK MILLER MD 875 SOUTH VANGUARD WAY, SUITE 120 MERIDIAN, ID 83642
Mailing Address: IAA, KIRK MILLER MD STE 120 875 S VANGUARD WAY MERIDIAN, ID 83642-8541

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
INTERMOUNTAIN AMBULATORY ANESTHESIA, PLLC PROFIT SHARING PLAN 2023 522314761 2024-10-10 INTERMOUNTAIN AMBULATORY ANESTHESIA, PLLC 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-05-01
Business code 621111
Sponsor’s telephone number 2088637266
Plan sponsor’s address 875 SOUTH VANGUARD WAY, MERIDIAN, ID, 83642

Signature of
Role Plan administrator
Date 2024-10-10
Name of individual signing KIRK MILLER
Valid signature Filed with authorized/valid electronic signature
INTERMOUNTAIN AMBULATORY ANESTHESIA, PLLC PROFIT SHARING PLAN 2022 522314761 2023-10-12 INTERMOUNTAIN AMBULATORY ANESTHESIA, PLLC 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-05-01
Business code 621111
Sponsor’s telephone number 2088637266
Plan sponsor’s address 875 SOUTH VANGUARD WAY, MERIDIAN, ID, 83642

Signature of
Role Plan administrator
Date 2023-10-12
Name of individual signing KIRK MILLER
Valid signature Filed with authorized/valid electronic signature
INTERMOUNTAIN AMBULATORY ANESTHESIA, PLLC PROFIT SHARING PLAN 2021 522314761 2022-10-13 INTERMOUNTAIN AMBULATORY ANESTHESIA, PLLC 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-05-01
Business code 621111
Sponsor’s telephone number 2088637266
Plan sponsor’s address 875 SOUTH VANGUARD WAY, MERIDIAN, ID, 83642

Signature of
Role Plan administrator
Date 2022-10-13
Name of individual signing KIRK MILLER
Valid signature Filed with authorized/valid electronic signature
INTERMOUNTAIN AMBULATORY ANESTHESIA, PLLC PROFIT SHARING PLAN 2020 522314761 2022-01-25 INTERMOUNTAIN AMBULATORY ANESTHESIA, PLLC 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-05-01
Business code 621111
Sponsor’s telephone number 2088637266
Plan sponsor’s address 1417 NORTH 19TH STREET, BOISE, ID, 83702

Signature of
Role Plan administrator
Date 2022-01-25
Name of individual signing KIRK MILLER
Valid signature Filed with authorized/valid electronic signature
INTERMOUNTAIN AMBULATORY ANESTHESIA, PLLC PROFIT SHARING PLAN 2019 522314761 2020-10-29 INTERMOUNTAIN AMBULATORY ANESTHESIA, PLLC 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-05-01
Business code 621111
Sponsor’s telephone number 2088637266
Plan sponsor’s address 600 ROBBINS ROAD, SUITE 400, BOISE, ID, 83702

Signature of
Role Plan administrator
Date 2020-10-29
Name of individual signing KIRK MILLER
Valid signature Filed with authorized/valid electronic signature
INTERMOUNTAIN AMBULATORY ANESTHESIA, PLLC PROFIT SHARING PLAN 2019 522314761 2020-10-08 INTERMOUNTAIN AMBULATORY ANESTHESIA, PLLC 3
Three-digit plan number (PN) 001
Effective date of plan 2003-05-01
Business code 621111
Sponsor’s telephone number 2088637266
Plan sponsor’s address 600 ROBBINS ROAD, SUITE 400, BOISE, ID, 83702

Signature of
Role Plan administrator
Date 2020-10-08
Name of individual signing KIRK MILLER
Valid signature Filed with authorized/valid electronic signature
INTERMOUNTAIN AMBULATORY ANESTHESIA, PLLC PROFIT SHARING PLAN 2018 522314761 2020-10-29 INTERMOUNTAIN AMBULATORY ANESTHESIA, PLLC 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-05-01
Business code 621111
Sponsor’s telephone number 2088637266
Plan sponsor’s address 600 ROBBINS ROAD, SUITE 400, BOISE, ID, 83702

Signature of
Role Plan administrator
Date 2020-10-29
Name of individual signing KIRK MILLER
Valid signature Filed with authorized/valid electronic signature
INTERMOUNTAIN AMBULATORY ANESTHESIA, PLLC PROFIT SHARING PLAN 2018 522314761 2019-07-31 INTERMOUNTAIN AMBULATORY ANESTHESIA, PLLC 3
Three-digit plan number (PN) 001
Effective date of plan 2003-05-01
Business code 621111
Sponsor’s telephone number 2088637266
Plan sponsor’s address 600 ROBBINS ROAD, SUITE 400, BOISE, ID, 83702

Signature of
Role Plan administrator
Date 2019-07-31
Name of individual signing KIRK MILLER
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
KIRK A MILLER MD Agent 1417 N 19TH ST, BOISE, ID 83702

Manager

Name Role Address Appointed On
KIRK MILLER Manager 1417 N 19TH ST, BOISE, ID 83702 2021-03-03

Member

Name Role Address Appointed On Resigned On
RYAN JENSEN Member 1766 N HIGHBURY WAY, EAGLE, ID 83616 2024-03-04 2024-03-04
NATE RAWLINS Member 5472 S MCCURRY WAY, MERIDIAN, ID 83642 2024-03-04 2024-03-04
Cory Lewis Member 875 S VANGUARD WAY STE 120, MERIDIAN, ID 83642 2024-03-04 No data
JAMES ERNEST Member 15576 TOSCANO PLACE, CALDWELL, ID 83607 2024-03-04 2024-03-04
Jeanne DeBarto Member 875 S VANGUARD WAY STE 120, MERIDIAN, ID 83642 2024-03-04 No data

Filing

Filing Name Filing Number Filing date
Annual Report 0006138175 2025-03-03
Annual Report 0005633061 2024-03-04
Annual Report 0005154727 2023-03-13
Annual Report 0004632655 2022-03-03
Amendment to Certificate 0004414384 2021-09-10
Annual Report 0004191915 2021-03-03
Statement of Change of Business Mailing Address 0004028547 2020-10-08
Annual Report 0003794241 2020-03-03
Annual Report 0003523744 2019-05-24
Annual Report 0001146468 2018-07-05

Paycheck Protection Program

Loan Number Loan Funded Date SBA Origination Office Code Loan Delivery Method Borrower Street Address
3572967108 2020-04-11 1087 PPP 600 N Robbins Rd, BOISE, ID, 83702-4539
Loan Status Date 2022-02-12
Loan Status Paid in Full
Loan Maturity in Months 24
SBA Guaranty Percentage 100
Loan Approval Amount (at origination) 90000
Loan Approval Amount (current) 90000
Undisbursed Amount 0
Franchise Name -
Lender Location ID 56102
Servicing Lender Name KeyBank National Association
Servicing Lender Address 127 Public Sq, CLEVELAND, OH, 44114-1217
Rural or Urban Indicator U
Hubzone N
LMI N
Business Age Description Unanswered
Project Address BOISE, ADA, ID, 83702-4539
Project Congressional District ID-02
Number of Employees 3
NAICS code 621493
Borrower Race Unanswered
Borrower Ethnicity Unknown/NotStated
Business Type Limited Liability Company(LLC)
Originating Lender ID 56102
Originating Lender Name KeyBank National Association
Originating Lender Address CLEVELAND, OH
Gender Unanswered
Veteran Unanswered
Forgiveness Amount 91060.27
Forgiveness Paid Date 2021-06-25

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Date of last update: 30 Mar 2025

Sources: Idaho Secretary of State

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