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EAGLE ROCK ANESTHESIA, PLLC

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Company Details

Name: EAGLE ROCK ANESTHESIA, PLLC
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: 83404
County: Bonneville County
Principal Address: 5351 SPIRIT COVE IDAHO FALLS, ID 83404
Mailing Address: Travis Pickett 5341 TILDY LN IDAHO FALLS, ID 83401-6038

Agent

Name Role Address
TRAVIS M PICKETT Agent 5341 E TILDY LN, IDAHO FALLS, ID 83401

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

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
Annual Report 0006004053 2024-12-03
Annual Report 0005493367 2023-12-03
Annual Report 0005010169 2022-12-04
Annual Report 0004520534 2021-12-07
Annual Report 0004090138 2020-12-06

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Date of last update: 23 Jun 2025

Sources: Idaho Secretary of State