Individual provider Active NPI

Kristen Ann Riley, CCC-SLP

  • Speech-Language Pathologist
  • Salem, OR
National Provider Identifier
1164879813
Registry record updated Aug 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
17043 Issued in OR
Practice address
3333 Hidden Valley Dr NW
Salem, OR 97304-2322
Phone
(773) 580-8625
NPI assigned
May 23, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 31, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 32490 CA
Speech-Language Pathologist 235Z00000X 17043 OR Primary
Speech-Language Pathologist 235Z00000X 242003771 IL

Addresses

Primary practice location

3333 Hidden Valley Dr NW
Salem, OR 97304-2322

Mailing address

3333 Hidden Valley Dr NW
Salem, OR 97304-2322
Phone (773) 580-8625

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251031001738 CA Practitioner - Qualified Speech Language Pathologist 9537691027 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 2014
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1111 B S Governors Ave
Suite 3995
Dover, DE 19904-6903

461 2ND St
Apt C309
San Francisco, CA 94107-1449

489 Sanchez St
San Francisco, CA 94114-2056

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
32490CAMDPsychologist
242003771ILMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Hona Medical Group of California PC Speech-Language Pathologist CurrentSince Aug 17, 2025 Accepting new patients
Childrens Care Translation Center 2 Inc Speech-Language Pathologist Past Accepting new patients

Locations

95 3rd St
San Francisco, CA 94103
Phone (414) 640-9090

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1463961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725062400000",
    "number": "1164879813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3333 HIDDEN VALLEY DR NW",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973042322",
            "telephone_number": "773-580-8625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3333 HIDDEN VALLEY DR NW",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973042322",
            "telephone_number": "773-580-8625"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RILEY",
        "first_name": "KRISTEN",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-05-23",
        "last_updated": "2024-08-31",
        "certification_date": "2024-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CA",
            "license": "32490",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "OR",
            "license": "17043",
            "primary": true
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": "242003771",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.