GREAT LAKES FAMILY CHIROPRACTIC, INC.
NPI 1811975717
Chiropractor in Kentwood, MI

Q: What is Great Lakes Family Chiropractic, Inc.'s specialty?

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

Active since January 03, 2006

3138 BROADMOOR AVE SE, KENTWOOD, MI 49512(616) 241-4040(616) 475-6953 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: October 18, 2026.

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About Great Lakes Family Chiropractic, Inc. NPPES

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

GREAT LAKES FAMILY CHIROPRACTIC, INC. (NPI 1811975717) is a healthcare organization registered as a chiropractor in Kentwood, Michigan and active in the NPI registry since January 2006. The organization lists Douglas Gene Mckenzie, Dr. Owner, as its authorized official.

NPPES Registry Identity

NPI1811975717

Entity TypeOrganization

Primary Taxonomy111N00000X

Legal Business NameGREAT LAKES FAMILY CHIROPRACTIC, INC.

Location Address3138 BROADMOOR AVE SEKentwood, MI 49512-1845

Mailing Address3138 Broadmoor Ave SeKentwood, MI 49512-1845 · (616) 241-4040 · Fax (616) 475-6953

Phone(616) 241-4040

Fax(616) 475-6953

Organization SubpartNo

Authorized OfficialDouglas Gene MckenzieDr. Owner · (616) 241-4040

Enumeration DateJanuary 3, 2006

Last NPPES UpdateAugust 22, 2020

✔ NPI 1811975717 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyChiropractorChiropractic Providers

Taxonomy Code111N00000X

License✔ Licensed in MI · 2301008451

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.

3138 BROADMOOR AVE SE, Kentwood, MI 49512

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Other Identifiers 1

Medicaid4754106MI

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Care Network of Michigan, Blue Cross Blue Shield of Michigan Mutual Insurance Company.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)

Great Lakes Family Chiropractic, Inc. 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 Great Lakes Family Chiropractic, Inc., which bills Medicare for the services this clinician delivers.

Clinician (1)

Douglas Mckenzie, D.C.

Chiropractic

NPI 1902928724

3138 BROADMOOR AVE SE
Kentwood, MI 49512

(616) 241-4040

✔ Accepts MedicareSame address

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

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 Great Lakes Family Chiropractic, Inc.'s NPI number?

The NPI number for Great Lakes Family Chiropractic, Inc. is 1811975717. It was assigned to this organization in the NPPES registry on January 3, 2006.

Where is Great Lakes Family Chiropractic, Inc. located?

Great Lakes Family Chiropractic, Inc. is located at 3138 Broadmoor Ave SE, Kentwood, MI 49512. The listed phone number is (616) 241-4040.

What is Great Lakes Family Chiropractic, Inc.'s specialty?

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

Is Great Lakes Family Chiropractic, Inc. enrolled in Medicare?

Yes. Great Lakes Family Chiropractic, Inc. is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Great Lakes Family Chiropractic, Inc.?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Chiropractic) reassigns their Medicare billing to Great Lakes Family Chiropractic, Inc.. 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.

What insurance does Great Lakes Family Chiropractic, Inc. accept?

Health plans from Blue Care Network of Michigan and Blue Cross Blue Shield of Michigan Mutual Insurance Company list Great Lakes Family Chiropractic, Inc. 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 Great Lakes Family Chiropractic, Inc. was last updated on August 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years 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.