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PAIN MANAGEMENT OF NORTH IDAHO, PLLC

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Company Details

Name: PAIN MANAGEMENT OF NORTH IDAHO, PLLC
Jurisdiction: Idaho
Legal type: Limited Liability Company (D)
Status: Active-Existing
Date of registration: 07 May 2001 (24 years ago)
Financial Date End: 31 May 2026
Entity Number: 59843
Place of Formation: IDAHO
File Number: 59843
ZIP code: 83814
County: Kootenai County
Principal Address: 1686 W. RIVERSTONE DR. #1 COEUR D ALENE, ID 83814
Mailing Address: 1686 W RIVERSTONE DR # 1 COEUR D ALENE, ID 83814-5779

Agent

Name Role Address
SCOTT MAGNUSON Agent 1686 W. RIVERSTONE DR. #1, COEUR D'ALENE, ID 83814

Manager

Name Role Address Appointed On Resigned On
Michel A Magnuson Manager 1686 W RIVERSTONE DR, COEUR D ALENE, ID 83814-5779 2024-04-10 2024-04-10

Member

Name Role Address Appointed On
Scott K Magnuson Member 1686 W RIVERSTONE DR, COEUR D ALENE, ID 83814-5779 2021-04-07

National Provider Identifier

NPI Number:
1467583153
Certification Date:
2023-03-14

Authorized Person:

Name:
DR. SCOTT KARL MAGNUSON
Role:
PHYSICIAN
Phone:

Taxonomy:

Selected Taxonomy:
208VP0014X - Interventional Pain Medicine Physician
Is Primary:
Yes

Contacts:

Fax:
2087652903

Form 5500 Series

Employer Identification Number (EIN):
820531718
Plan Year:
2023
Number Of Participants:
26
Sponsors Telephone Number:
Plan Year:
2023
Number Of Participants:
26
Sponsors Telephone Number:
Plan Year:
2022
Number Of Participants:
25
Sponsors Telephone Number:
Plan Year:
2021
Number Of Participants:
24
Sponsors Telephone Number:
Plan Year:
2020
Number Of Participants:
18
Sponsors Telephone Number:

Filing

Filing Name Filing Number Filing date
Annual Report 0006202163 2025-04-09
Annual Report 0005687433 2024-04-10
Annual Report 0005182871 2023-04-05
Annual Report 0004690609 2022-04-06
Annual Report 0004239063 2021-04-07

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:
231518.00
Total Face Value Of Loan:
231518.00

Paycheck Protection Program

Date Approved:
2020-04-15
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Initial Approval Amount:
231518
Current Approval Amount:
231518
Race:
Unanswered
Ethnicity:
Unknown/NotStated
Gender:
Unanswered
Veteran:
Unanswered
Forgiveness Amount:
233010

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Date of last update: 23 Jun 2025

Sources: Idaho Secretary of State