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  5. The Orthopedic Surgery and Sports Medicine Clinic, PLLC

The Orthopedic Surgery and Sports Medicine Clinic, PLLC

Company Details

Name: The Orthopedic Surgery and Sports Medicine Clinic, PLLC
Jurisdiction: Idaho
Legal type: Limited Liability Company (D)
Status: Active-Existing
Date of registration: 04 Jun 2001 (24 years ago)
Financial Date End: 30 Jun 2025
Entity Number: 60752
Place of Formation: IDAHO
File Number: 60752
ZIP code: 83814
County: Kootenai County
Principal Address: STE 202 850 W IRONWOOD DR COEUR D ALENE, ID 83814-4903

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
ORTHOPEDIC SURGERY AND SPORTS MEDICINE CLINIC 401(K) PROFIT SHARING PLAN 2023 043718451 2024-09-24 ORTHOPEDIC SURGERY AND SPORTS MEDICINE CLINIC 66
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2000-01-01
Business code 621111
Sponsor’s telephone number 2086642175
Plan sponsor’s address 850 IRONWOOD DRIVE, SUITE 202, COEUR DALENE, ID, 83814

Signature of
Role Plan administrator
Date 2024-09-24
Name of individual signing SCOTT BROWN
Valid signature Filed with authorized/valid electronic signature
ORTHOPEDIC SURGERY AND SPORTS MEDICINE CLINIC 401(K) PROFIT SHARING PLAN 2022 043718451 2023-09-21 ORTHOPEDIC SURGERY AND SPORTS MEDICINE CLINIC 78
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2000-01-01
Business code 621111
Sponsor’s telephone number 2086642175
Plan sponsor’s address 850 IRONWOOD DRIVE, SUITE 202, COEUR DALENE, ID, 83814

Signature of
Role Plan administrator
Date 2023-09-21
Name of individual signing SCOTT BROWN
Valid signature Filed with authorized/valid electronic signature
ORTHOPEDIC SURGERY AND SPORTS MEDICINE CLINIC 401(K) PROFIT SHARING PLAN 2021 043718451 2022-10-12 ORTHOPEDIC SURGERY AND SPORTS MEDICINE CLINIC 73
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2000-01-01
Business code 621111
Sponsor’s telephone number 2086642175
Plan sponsor’s address 850 IRONWOOD DRIVE, SUITE 202, COEUR DALENE, ID, 83814

Signature of
Role Plan administrator
Date 2022-10-12
Name of individual signing SCOTT BROWN
Valid signature Filed with authorized/valid electronic signature
ORTHOPEDIC SURGERY AND SPORTS MEDICINE CLINIC 401(K) PROFIT SHARING PLAN 2020 043718451 2021-08-24 ORTHOPEDIC SURGERY AND SPORTS MEDICINE CLINIC 64
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2000-01-01
Business code 621111
Sponsor’s telephone number 2086642175
Plan sponsor’s address 850 IRONWOOD DRIVE, SUITE 202, COEUR DALENE, ID, 83814

Signature of
Role Plan administrator
Date 2021-08-24
Name of individual signing SCOTT BROWN
Valid signature Filed with authorized/valid electronic signature
ORTHOPEDIC SURGERY AND SPORTS MEDICINE CLINIC 401(K) PROFIT SHARING PLAN 2019 043718451 2020-10-08 ORTHOPEDIC SURGERY AND SPORTS MEDICINE CLINIC 50
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2000-01-01
Business code 621111
Sponsor’s telephone number 2086642175
Plan sponsor’s address 850 IRONWOOD DRIVE, SUITE 202, COEUR DALENE, ID, 83814

Signature of
Role Plan administrator
Date 2020-10-08
Name of individual signing SCOTT BROWN
Valid signature Filed with authorized/valid electronic signature
ORTHOPEDIC SURGERY AND SPORTS MEDICINE CLINIC 401(K) PROFIT SHARING PLAN 2018 043718451 2019-10-09 ORTHOPEDIC SURGERY AND SPORTS MEDICINE CLINIC 42
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2000-01-01
Business code 621111
Sponsor’s telephone number 2086642175
Plan sponsor’s address 850 IRONWOOD DRIVE, SUITE 202, COEUR DALENE, ID, 83814

Signature of
Role Plan administrator
Date 2019-10-09
Name of individual signing SCOTT BROWN
Valid signature Filed with authorized/valid electronic signature
ORTHOPEDIC SURGERY AND SPORTS MEDICINE CLINIC 401(K) PROFIT SHARING PLAN 2017 043718451 2019-12-05 ORTHOPEDIC SURGERY AND SPORTS MEDICINE CLINIC 31
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2000-01-01
Business code 621111
Sponsor’s telephone number 2086642175
Plan sponsor’s address 850 IRONWOOD DRIVE, SUITE 202, COEUR DALENE, ID, 83814

Signature of
Role Plan administrator
Date 2019-12-05
Name of individual signing SCOTT BROWN
Valid signature Filed with authorized/valid electronic signature
ORTHOPEDIC SURGERY AND SPORTS MEDICINE CLINIC 401(K) PROFIT SHARING PLAN 2017 043718451 2018-10-12 ORTHOPEDIC SURGERY AND SPORTS MEDICINE CLINIC 31
Three-digit plan number (PN) 001
Effective date of plan 2000-01-01
Business code 621111
Sponsor’s telephone number 2086642175
Plan sponsor’s address 850 IRONWOOD DRIVE, SUITE 202, COEUR DALENE, ID, 83814

Signature of
Role Plan administrator
Date 2018-10-12
Name of individual signing WILLIAM F. SIMS
Valid signature Filed with authorized/valid electronic signature
ORTHOPEDIC SURGERY AND SPORS MEDICINE CLINIC 401(K) PROFIT SHARING PLAN 2016 043718451 2017-10-03 ORTHOPEDIC SURGERY AND SPORTS MEDICINE CLINIC 31
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2000-01-01
Business code 621111
Sponsor’s telephone number 2086642175
Plan sponsor’s address 850 IRONWOOD DRIVE, SUITE 202, COEUR DALENE, ID, 83814

Signature of
Role Plan administrator
Date 2017-10-03
Name of individual signing WILLIAM F. SIMS
Valid signature Filed with authorized/valid electronic signature
ORTHOPEDIC SURGERY AND SPORS MEDICINE CLINIC 401(K) PROFIT SHARING PLAN 2015 043718451 2016-10-07 ORTHOPEDIC SURGERY AND SPORTS MEDICINE CLINIC 20
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2000-01-01
Business code 621111
Sponsor’s telephone number 2086642175
Plan sponsor’s address 850 IRONWOOD DRIVE, SUITE 202, COEUR DALENE, ID, 83814

Signature of
Role Plan administrator
Date 2016-10-07
Name of individual signing WILLIAM F. SIMS
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
ROGER C DUNTEMAN Agent 850 W IRONWOOD DR, STE 202, COEUR D ALENE, ID 83814

Manager

Name Role Address Appointed On
Roger Dunteman MD Manager 850 W IRONWOOD DR, COEUR D ALENE, ID 83814 2021-09-28

Member

Name Role Address Appointed On
Justin Luke Smith DO Member 850 W IRONWOOD DR, COEUR D ALENE, ID 83814 2024-05-06
Gregory Keese MD Member 850 W IRONWOOD DR, COEUR D ALENE, ID 83814 2024-05-06
Jonathan King MD Member 850 W IRONWOOD DR, COEUR D ALENE, ID 83814 2024-05-06
Scott Brown DO Member 850 W IRONWOOD DR, COEUR D ALENE, ID 83814 2024-05-06
Douglas McInnis MD Member 850 W IRONWOOD DR, COEUR D ALENE, ID 83814 2024-05-06
William Sims MD Member 850 W IRONWOOD DR, COEUR D ALENE, ID 83814 2024-05-06

Filing

Filing Name Filing Number Filing date
Annual Report 0005724544 2024-05-06
Annual Report 0005222073 2023-05-03
Annual Report 0004747171 2022-05-14
Annual Report Amendment 0004671885 2022-03-24
Application for Reinstatement 0004429420 2021-09-28
Dissolution/Revocation - Administrative 0004413458 2021-09-10
Annual Report 0003864501 2020-05-04
Statement of Conversion 0003529508 2019-05-24
Annual Report 0003513305 2019-05-15
Annual Report 0001151190 2018-04-25

Related by officers

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Scott Brown DO

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William Sims MD

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Related by address

STE 202 850 W IRONWOOD DR COEUR D ALENE, ID 83814-4903

O.S.S.M. LANDHOLDING, L.L.C. SCOTT A. BROWN, DO, PLLC DSMB LANDHOLDING, LLC DOUGLAS P. MCINNIS, MD, PC WILLIAM F. SIMS, MD, PA JONATHAN S. KING, M.D., P.C. OPTI LANDHOLDINGS, LLC ROGER C. DUNTEMAN, MD, PC GREGORY R. KEESE, M.D., P.C.

Date of last update: 28 Nov 2024

Sources: Idaho Secretary of State

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