Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Kenneth Edward Squires III, DO

Individual provider Psychiatry Physician · NPI 1649706326

Kenneth Edward Squires III, DO is a Psychiatry in Boise, Idaho. Graduated from Kansas City University of Med & Biosciences, College of Osteo Med in 2017, 9 years ago. Practices with Saint Alphonsus Regional Medical Center Inc, a 673-clinician group, works from 2 locations, accepts Medicare assignment and offers telehealth. Licensed in Idaho and Oregon.

Years since qualifying
9
Trained at
Kansas City University of Med & Biosciences, College of Osteo Med
Licensed in
ID, OR
In the registry since
2017
Specialties on file
2
What do these letters mean?
DO — Doctor of Osteopathic Medicine
A fully licensed physician, trained like an MD with additional musculoskeletal training. Equivalent practice rights in all 50 states.

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Practice location Address checks out

6348 W Emerald St
Boise, ID 83704-8732
Phone: (208) 302-0900
Fax: (208) 302-0955
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 3600 Nw Samaritan Dr, Corvallis, OR 97330-3737 — (541) 768-4906

Specialties & licences

Psychiatry Physician (primary) Taxonomy 2084P0800X · Licence O-1978 (ID)
Psychiatry Physician Taxonomy 2084P0800X · Licence PG183059 (OR)

Record details

NPI number1649706326
Entity typeIndividual (Type 1)
GenderMale
Credentials DO
Sole proprietorNo
NPI enumeratedMay 2, 2017
Last updated in NPPESMay 15, 2024
Certification dateMay 15, 2024
Mailing addressPo Box 190930, Boise, ID 83719-0930

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPSYCHIATRY
Medical schoolKANSAS CITY UNIVERSITY OF MED & BIOSCIENCES, COLLEGE OF OSTEO MED
Graduated 2017 (9 years in practice)
Group practice Saint Alphonsus Regional Medical Center Inc — 673 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations2 on file with Medicare

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