Healthcare Provider Details

I. General information

NPI: 1073123220
Provider Name (Legal Business Name): JEMERICUS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/03/2020
Last Update Date: 04/22/2026
Certification Date: 04/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 W MAIN ST STE 1460
BOISE ID
83702-5983
US

IV. Provider business mailing address

800 W MAIN ST STE 1460
BOISE ID
83702-5983
US

V. Phone/Fax

Practice location:
  • Phone: 208-297-4091
  • Fax:
Mailing address:
  • Phone: 208-297-4091
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: JEREMY JASON SLOYER
Title or Position: PRESIDENT/PROVIDER
Credential:
Phone: 208-297-4091