Caroline M Riley, M.S., CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SLP-4298 Issued in ID

Practice address

113 Main Street
Kimberly, ID 83341

Phone

(208) 421-9659

Fax

(208) 268-3878

NPI assigned

Jun 10, 2020

Last updated

Dec 16, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in ID

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

Practice roles

Locations

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

• Makona Therapy Services, LLC

  • Speech-Language Pathologist
  • Kimberly, ID
  • NPI 1013592575
  Medicare reassignment NPD

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

{
    "created_epoch": "1591747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639612800000",
    "number": "1386269983",
    "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": "208-421-9659",
            "fax_number": "208-268-3878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "113 MAIN STREET",
            "city": "KIMBERLY",
            "state": "ID",
            "postal_code": "83341",
            "telephone_number": "208-421-9659",
            "fax_number": "208-268-3878"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RILEY",
        "first_name": "CAROLINE",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "M.S., CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-06-10",
        "last_updated": "2021-12-16",
        "certification_date": "2021-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "ID",
            "license": "SLP-4298",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201830028",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sheri Lynn Remming, MS, LCPC, NCC
• Whitney Retter
• Tyler Richardson, LCSW
• Adam Thomas Richins, PA-C
• Ridley's Family Markets, Inc (Ridley's Pharmacy #8464)
• Amy Roemer
• Daniel Stark Russon, DPT, PT
• Travis Trent Shepherd, DMD
• Julie Becca Sirucek
• Michelle M Smith, DPT, PT

• 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 Dec 16, 2021; 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.