REVIVE PAIN SOLUTIONS GRAND RAPIDS NPI 1962393306

NPI Information

  • NPI: 1962393306
  • Provider Name: REVIVE PAIN SOLUTIONS GRAND RAPIDS
  • Classification: Pain Medicine - 208VP0014X
  • Specialization: Interventional Pain Medicine
  • Entity Type: Organization
  • Address: 6140 28TH ST SE STE 105
    GRAND RAPIDS, MI
    ZIP 49546
  • Phone: (616) 822-1509

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NPI Details

REVIVE PAIN SOLUTIONS GRAND RAPIDS is an interventional pain medicine pain medicine in Grand Rapids, MI. The provider is interventional Pain Medicine is the discipline of medicine devoted to the diagnosis and treatment of pain and related disorders principally with the application of interventional techniques in managing subacute, chronic, persistent, and intractable pain, independently or in conjunction with other modalities of treatment. REVIVE PAIN SOLUTIONS GRAND RAPIDS NPI is 1962393306. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

6140 28TH ST SE STE 105
GRAND RAPIDS, MI
ZIP 49546-938
Phone: (616) 822-1509

The provider's authorized official is Thomas M. Basch .
The authorized official title is Supervising Physician and has the following contact phone number (616) 822-1509.

The enumeration date for this NPI number is 7/14/2025 and was last updated on 10/17/2025.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1208VP0014XPain MedicineInterventional Pain MedicineYes

What is NPI?

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This page was last updated on: 11/21/2025

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