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EAGLE ROCK ANESTHESIA, LLC

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Company Details

Name: EAGLE ROCK ANESTHESIA, LLC
Jurisdiction: Idaho
Legal type: Limited Liability Company (D)
Status: Active-Existing
Date of registration: 08 Jan 2003 (23 years ago)
Financial Date End: 31 Jan 2026
Entity Number: 80095
Place of Formation: IDAHO
File Number: 80095
ZIP code: 83406
County: Bonneville County
Principal Address: JAXON ANDERSON 2325 CORONADO STREET IDAHO FALLS, ID 83406
Mailing Address: JAXON ANDERSON 2325 CORONADO ST IDAHO FALLS, ID 83406

Manager

Name Role Address Appointed On Resigned On
Travis Pickett Manager 5341 E. TILDY LN., IDAHO FALLS, ID 83401 2020-12-06 No data
Travis Pickett Manager 5341 EAST TILDY LANE, IDAHO FALLS, ID 83401 2020-10-03 2020-12-06

Agent

Name Role Address
Jaxon Anderson Agent 143 E MAIN ST # 150, RIGBY, ID 83442-1417

National Provider Identifier

NPI Number:
1871761395

Authorized Person:

Name:
DR. SCOTT C NELSON
Role:
MEMBER
Phone:

Taxonomy:

Selected Taxonomy:
207L00000X - Anesthesiology Physician
Is Primary:
Yes

Contacts:

Fax:
2085232025

Form 5500 Series

Employer Identification Number (EIN):
841615214
Plan Year:
2023
Number Of Participants:
7
Sponsors Telephone Number:
Plan Year:
2022
Number Of Participants:
7
Sponsors Telephone Number:

Filing

Filing Name Filing Number Filing date
Amendment to Certificate 0006404107 2025-08-19
Statement of Change of Business Mailing Address 0006359858 2025-07-15
Change of Registered Office/Agent/Both (by Entity) 0006359865 2025-07-15
Annual Report 0006004053 2024-12-03
Annual Report 0005493367 2023-12-03

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Date of last update: 27 Aug 2025

Sources: Idaho Secretary of State