Individual provider Active NPI

Alexis Anna-Mae Kughn

  • Social Worker
  • Grand Rapids, MI
National Provider Identifier
1417878380
Registry record updated Jul 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
6851117409 Issued in MI
Practice address
2750 E Beltline Ave NE
Grand Rapids, MI 49525-8614
Phone
(616) 447-5820
NPI assigned
Jul 24, 2026
Last updated
Jul 24, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 6851117409 MI Primary

Addresses

Primary practice location

2750 E Beltline Ave NE
Grand Rapids, MI 49525-8614

Mailing address

100 Corewell Dr NW
Grand Rapids, MI 49503-2041
Phone (866) 989-7999

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1784851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784851200000",
    "number": "1417878380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 COREWELL DR NW",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495032041",
            "telephone_number": "866-989-7999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2750 E BELTLINE AVE NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495258614",
            "telephone_number": "616-447-5820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUGHN",
        "first_name": "ALEXIS",
        "middle_name": "ANNA-MAE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-07-24",
        "last_updated": "2026-07-24",
        "certification_date": "2026-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6851117409",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.