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DR. KEVIN LAWRENCE BOUDREAU D.C.
NPI 1679516223
Chiropractor in Gladstone, MI

Active since June 13, 2006Accepts Medicare Assignment
116 N 9TH ST, SUITE A, GLADSTONE, MI 49837(906) 428-9640(906) 428-9641 Get Directions Write a Review

NPPES record last updated: July 13, 2026. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Dr. Kevin Lawrence Boudreau D.c. NPPES

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

DR. KEVIN LAWRENCE BOUDREAU D.C. (NPI 1679516223) is an individual chiropractor in Gladstone, Michigan, licensed in Michigan (2301008810) and active in the NPI registry since June 2006. He is a graduate of Palmer College Chiropractic - Davenport (2004).

NPPES Registry Identity

NPI1679516223
Entity TypeIndividualMale
Primary Taxonomy111N00000X
Provider Legal NameDR. KEVIN LAWRENCE BOUDREAUCredential: D.C.
Location Address116 N 9TH ST, SUITE AGladstone, MI 49837-1645
Mailing Address116 N 9th St, Suite AGladstone, MI 49837-1645 · (906) 428-9640 · Fax (906) 428-9641
Phone(906) 428-9640
Fax(906) 428-9641
Sole ProprietorNo
Medical School CMSPalmer College Chiropractic - DavenportGraduated 2004
Enumeration DateJune 13, 2006
Last NPPES UpdateJuly 13, 2026
✔ NPI 1679516223 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyChiropractorChiropractic Providers
Taxonomy Code111N00000X
License✔ Licensed in MI · 2301008810
Definition
A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems.
116 N 9TH ST, Gladstone, MI 49837
Open in Google Maps ↗

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Kevin Lawrence Boudreau D.c. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID4486619897
PECOS Enrollment IDI20041129000137

Medicare Billing Reassignment

Medicare enrollment records show Kevin Boudreau reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Bay De Noc Chiropractic Center, P.C.
0.2 mi
Chiropractor
116 N 9TH ST, SUITE A
Gladstone, MI 49837
  • Reassigned Medicare billing, Michigan enrollment
  • Medicare enrollment name: Bay De Noc Chiropractic Center PC
NPI 1306061296 (906) 428-9640

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Chiropractic manipulative treatment, 3-4 spinal regions 98941
Chiropractic manipulative treatment for 3-4 spinal regions involves a trained professional applying controlled force to specific areas of your spine. This can help alleviate pain, improve physical function, and support your body's natural healing process.
547 services54 patients

Other Providers at the Same Location NPPES

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

BAY DE NOC CHIROPRACTIC CENTER, P.C.
Chiropractor
116 N 9TH ST, SUITE A
GLADSTONE, MI 49837
Delta County (906) 428-9640

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 Kevin Boudreau's NPI number?

The NPI number for Kevin Boudreau is 1679516223. It was assigned to this individual provider in the NPPES registry on June 13, 2006.

Where is Kevin Boudreau located?

Kevin Boudreau practices at 116 N 9th St Suite A, Gladstone, MI 49837. The listed phone number is (906) 428-9640.

What is Kevin Boudreau's specialty?

The primary specialty registered for this NPI is Chiropractor with taxonomy code 111N00000X.

Is Kevin Boudreau enrolled in Medicare?

Yes. Kevin Boudreau is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organization bills Medicare for Kevin Boudreau's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Kevin Boudreau reassigns Medicare benefits to Bay De Noc Chiropractic Center, P.C. (Gladstone, MI). The 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 Kevin Boudreau's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Kevin Boudreau was last updated on July 13, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 months 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.