Individual provider Active NPI

Cortney Sue Krugman

  • Speech-Language Pathologist
  • Grand Rapids, MI
National Provider Identifier
1528864253
Registry record updated Apr 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
7101007620 Issued in MI
Practice address
3110 Ledgestone PL NE
Grand Rapids, MI 49525-7067
Phone
(616) 710-2817
NPI assigned
Feb 24, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 7101007620 MI Primary

Addresses

Primary practice location

3110 Ledgestone PL NE
Grand Rapids, MI 49525-7067

Mailing address

202 W Shiawassee Ave Ste 114
Fenton, MI 48430-2093
Phone (616) 710-2817

Other identifiers 1

IdentifierTypeStateIssuer
7101007620OtherMISTATE OF MICHIGAN SLP LICENSE

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

State licenses

LicenseStateTypeSpecialty
7101007620MIMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1740355200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743984000000",
    "number": "1528864253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "202 W SHIAWASSEE AVE STE 114",
            "city": "FENTON",
            "state": "MI",
            "postal_code": "484302093",
            "telephone_number": "616-710-2817"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3110 LEDGESTONE PL NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495257067",
            "telephone_number": "616-710-2817"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRUGMAN",
        "first_name": "CORTNEY",
        "middle_name": "SUE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-02-24",
        "last_updated": "2025-04-07",
        "certification_date": "2025-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MI",
            "license": "7101007620",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF MICHIGAN SLP LICENSE",
            "identifier": "7101007620",
            "state": "MI"
        }
    ],
    "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 Apr 7, 2025; 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.