Individual provider Active NPI

Kenneth Leif Nathaniel Sjoren, DO

  • Obstetrics & Gynecology Physician
  • Nampa, ID
National Provider Identifier
1093208134
Registry record updated Jun 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
O-1672 Issued in ID
Practice address
9850 W St Lukes Dr Ste 229
Nampa, ID 83687-7912
Phone
(208) 205-7700
Fax
(208) 205-7701
NPI assigned
Jun 13, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 23, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X O-1672 ID Primary
Obstetrics & Gynecology Physician 207V00000X DO219324 OR

Addresses

Primary practice location

9850 W St Lukes Dr Ste 229
Nampa, ID 83687-7912

Mailing address

190 E Bannock St
Boise, ID 83712-6241
Phone (208) 381-8866

Other practice location 1

840 SW 4th Ave Ste 105
Ontario, OR 97914-2638
Phone (541) 881-2800

Other practice location 2

207 E 12th St
Emmett, ID 83617-3626
Phone (208) 365-1065

Other identifiers 1

IdentifierTypeStateIssuer
500835019MedicaidOR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID, OR2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20220705002056 ID Practitioner - Obstetrics/Gynecology 2466832795 Reassigns benefits to 1 organization
I20240528001602 OR Practitioner - Obstetrics/Gynecology 2466832795 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Pacific NW Un of HS, Col of Osteopathic Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Valley Family Health Care IncGroup PAC ID 0547169591, 45 clinicians

Practice addresses (Care Compare)

1441 NE 10TH Ave
Payette, ID 83661-5420
Phone (208) 642-9376

207 E 12TH St
Emmett, ID 83617-3626
Phone (208) 365-1065

840 SW 4TH Ave
Ontario, OR 97914-2638
Phone (541) 881-2800

896 Fortner St
Ontario, OR 97914-1787
Phone (541) 881-2828

Hospital & facility affiliations

  • Saint Alphonsus Medical Center Ontario Hospital, Ontario, OR, CCN 380052

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of the uterus1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Valley Family Health Care, Inc CurrentSince May 20, 2024 Accepting new patients
Valley Family Health Care Inc CurrentSince May 20, 2024 Accepting new patients
Valley Family Health Care, Inc CurrentSince May 20, 2024 Accepting new patients

Locations

207 E 12th St
Emmett, ID 83617
Phone (208) 365-1065

1441 NE 10th Ave
Payette, ID 83661
Phone (208) 642-9376

17 S 3rd St
Nyssa, OR 97913
Phone (541) 372-5738

896 Fortner St
Ontario, OR 97914
Phone (541) 709-2038

840 SW 4th Ave
Ste 105
Ontario, OR 97914
Phone (541) 881-2500

789 Washington St W
Vale, OR 97918
Phone (503) 473-2101

Interoperability endpoints

  • Direct secure messaging: kleifsjoren701962@direct.ochin.org

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1528848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782172800000",
    "number": "1093208134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "190 E BANNOCK ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837126241",
            "telephone_number": "208-381-8866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9850 W ST LUKES DR STE 229",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836877912",
            "telephone_number": "208-205-7700",
            "fax_number": "208-205-7701"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "840 SW 4th Ave Ste 105",
            "address_purpose": "LOCATION",
            "city": "Ontario",
            "state": "OR",
            "postal_code": "979142638",
            "country_code": "US",
            "telephone_number": "541-881-2800",
            "fax_number": "541-881-2825",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "207 E 12th St",
            "address_purpose": "LOCATION",
            "city": "Emmett",
            "state": "ID",
            "postal_code": "836173626",
            "country_code": "US",
            "telephone_number": "208-365-1065",
            "fax_number": "208-365-1068",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SJOREN",
        "first_name": "KENNETH LEIF",
        "middle_name": "NATHANIEL",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-06-13",
        "last_updated": "2026-06-23",
        "certification_date": "2026-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "ID",
            "license": "O-1672",
            "primary": true
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "OR",
            "license": "DO219324",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500835019",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Nampa, ID

Sources for this page

Verify at the official NPI Registry.