GRAY REIGN MEDICAL, PLLC
NPI 1134909575
Family Medicine in Grand Rapids, MI
About Gray Reign Medical, Pllc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
GRAY REIGN MEDICAL, PLLC (NPI 1134909575) is a healthcare organization registered as a family medicine in Grand Rapids, Michigan and active in the NPI registry since October 2023. The organization holds a CLIA Waiver certificate valid through November 20, 2027 and lists Kadell Lewis, Office Manager, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Gray Reign Medical, Pllc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Gray Reign Medical, PLLC, which bills Medicare for the services this clinician delivers.
Clinician (1)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
CLIA Laboratory Certificates CMS CLIA
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate of Waiver 23D2294278
Gray Reign Medical · Grand Rapids, MIFrequently 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 Gray Reign Medical, PLLC's NPI number?
The NPI number for Gray Reign Medical, PLLC is 1134909575. It was assigned to this organization in the NPPES registry on October 3, 2023.
Where is Gray Reign Medical, PLLC located?
Gray Reign Medical, PLLC is located at 6255 28th St SE Ste 2, Grand Rapids, MI 49546. The listed phone number is (616) 980-0901.
What is Gray Reign Medical, PLLC's specialty?
The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.
Is Gray Reign Medical, PLLC enrolled in Medicare?
Yes. Gray Reign Medical, PLLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Gray Reign Medical, PLLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Family Practice) reassigns their Medicare billing to Gray Reign Medical, PLLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Gray Reign Medical, PLLC hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 23D2294278) is associated with this NPI, valid through November 20, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
What insurance does Gray Reign Medical, PLLC accept?
Health plans from Blue Care Network of Michigan and Blue Cross Blue Shield of Michigan Mutual Insurance Company list Gray Reign Medical, PLLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Gray Reign Medical, PLLC was last updated on September 28, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 32 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.
# Gray Reign Medical, Pllc · NPI 1134909575
Family Medicine organization in Grand Rapids, Michigan. Organization record, active in the CMS NPPES registry since October 3, 2023.
## Identity
- **NPI:** 1134909575 (Entity type: Organization)
- **Enumerated:** October 3, 2023
- **Primary specialty:** Family Medicine · taxonomy 207Q00000X
- **Organization subpart:** No
- **Authorized official:** Kadell Lewis, OFFICE MANAGER
## Practice location
- **Address:** 6255 28TH ST SE STE 2, Grand Rapids, MI 49546-6966
- **Phone:** (616) 980-0901 · **Fax:** (616) 980-2231
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1 clinician (Family Practice) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** September 28, 2026
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1134909575) · Data from the CMS NPPES public registry.