Makona Therapy Services, LLC

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

Legal business name

MAKONA THERAPY SERVICES, LLC

Practice address

113 Main Street N
Kimberly, ID 83341

Phone

(208) 421-9659

Fax

(208) 904-3947

NPI assigned

Mar 16, 2021

Organization subpart

No

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

Authorized official

Name

Mrs. Selina Puente

Title

Office Manager

Phone

(208) 904-3500

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in ID

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Caroline M Riley, M.S., CCC-SLP

  • Speech-Language Pathologist
  • Kimberly, ID
  • NPI 1386269983

  ID, Speech-Language Pathologist

  Medicare reassignment NPD
• Makeesa Moser, COTA

  • Occupational Therapy Assistant
  • Kimberly, ID
  • NPI 1649089251
  NPD (past)

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

{
    "created_epoch": "1615852800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1756339200000",
    "number": "1013592575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 MAIN ST N UNIT 182",
            "city": "KIMBERLY",
            "state": "ID",
            "postal_code": "833417008",
            "telephone_number": "208-904-3500",
            "fax_number": "208-904-3947"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "113 MAIN STREET N",
            "city": "KIMBERLY",
            "state": "ID",
            "postal_code": "83341",
            "telephone_number": "208-421-9659",
            "fax_number": "208-904-3947"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAKONA THERAPY SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-16",
        "last_updated": "2025-08-28",
        "certification_date": "2025-08-28",
        "status": "A",
        "authorized_official_last_name": "PUENTE",
        "authorized_official_first_name": "SELINA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "208-904-3500",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "IDTPID015531",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kent J Allen/ Shannon Widmier
• Kimberly School District
• Kalen Knopp
• Megan Dawn Kowitz, PHARM.D
• Diana Lincoln-Haye, LPC
• Chelsie Mansfield, RN
• Bailey Anne Medina
• Medsource Mobility LLC
• Albert Paul Middleton, PHARMD
• Angela Mooney, LPC

• Speech-Language Pathologist in Kimberly, ID
• Providers in Kimberly, ID by specialty
• Speech-Language Pathologist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.