1. Home
  2. Directory
  3. Michigan
  4. Grand Rapids
  5. Peer Specialist
  6. NPI Profile
Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

KELLY MARIE SHANGLE BSW
NPI 1457040784
Peer Specialist in Grand Rapids, MI

Active since May 03, 2023
260 JEFFERSON AVE SE, GRAND RAPIDS, MI 49503(616) 336-3909 Get Directions Write a Review

NPPES record last updated: August 21, 2026. Verified against the NPPES registry weekly; last sync: August 30, 2026.

Record update history: Aug 21, 2026, May 3, 2023 (2 updates tracked since 2023).

About Kelly Marie Shangle Bsw NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KELLY MARIE SHANGLE BSW (NPI 1457040784) is an individual peer specialist in Grand Rapids, Michigan and active in the NPI registry since May 2023.

NPPES Registry Identity

NPI1457040784
Entity TypeIndividualFemale
Primary Taxonomy175T00000X
Provider Legal NameKELLY MARIE SHANGLECredential: BSW
Location Address260 JEFFERSON AVE SEGrand Rapids, MI 49503-4597
Mailing Address260 Jefferson Ave SeGrand Rapids, MI 49503-4597 · (616) 336-3909
Phone(616) 336-3909
Sole ProprietorYes
Enumeration DateMay 3, 2023
Last NPPES UpdateAugust 21, 20262 updates tracked since enumeration
NPPES CertifiedAugust 21, 2026
✔ NPI 1457040784 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPeer SpecialistOther Service Providers
Taxonomy Code175T00000X
Definition
Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.
260 JEFFERSON AVE SE, Grand Rapids, MI 49503
Open in Google Maps ↗

Other Providers at the Same Location NPPES 10

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. SOUMYA CHOWDARY MADALA M.D.
Internal Medicine (Sleep Medicine)
260 JEFFERSON AVE SE, STE 300
GRAND RAPIDS, MI 49503
Kent County (616) 685-6330
REBECCA ANN LUDERS NP-C
Nurse Practitioner (Family)
260 JEFFERSON AVE SE, 206
GRAND RAPIDS, MI 49503
Kent County (616) 685-5430
WILLIAM HENRY BAER II M.D.
Internal Medicine
260 JEFFERSON AVE SE, SUITE 115
GRAND RAPIDS, MI 49503
Kent County (616) 685-3100
AMANDA GRAVES LLMSW
Social Worker
260 JEFFERSON AVE SE
GRAND RAPIDS, MI 49503
Kent County (616) 685-2700
EMILY TERESA SOTO PSS
Peer Specialist
260 JEFFERSON AVE SE
GRAND RAPIDS, MI 49503
Kent County (616) 336-3903
JOHN J STEPANOVICH DDS
Dentist
260 JEFFERSON AVE SE
GRAND RAPIDS, MI 49503
Kent County (616) 459-1267
GABRIELLE GRACE LMSW
Social Worker (Clinical)
260 JEFFERSON AVE SE
GRAND RAPIDS, MI 49503
Kent County (616) 336-3909
LISA MARIE ALFRIEND
Social Worker (Clinical)
260 JEFFERSON AVE SE
GRAND RAPIDS, MI 49503
Kent County (616) 336-3909

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kelly Shangle's NPI number?

The NPI number for Kelly Shangle is 1457040784. It was assigned to this individual provider in the NPPES registry on May 3, 2023.

Where is Kelly Shangle located?

Kelly Shangle practices at 260 Jefferson Ave SE, Grand Rapids, MI 49503. The listed phone number is (616) 336-3909.

What is Kelly Shangle's specialty?

The primary specialty registered for this NPI is Peer Specialist with taxonomy code 175T00000X.

When was this NPI record last updated?

The NPPES record for Kelly Shangle was last updated on August 21, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.