Revive Joint and Spine PLLC

Primary specialty

Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X

Legal business name

REVIVE JOINT AND SPINE PLLC

Practice address

23902 Ford Rd Ste a
Dearborn Heights, MI 48127-3289

Phone

(313) 777-7246

Fax

(313) 672-6222

NPI assigned

Jun 18, 2026

Last updated

Jun 18, 2026By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Mustafa Shukr, MDNPI 1952651671

Title

Medical Director

Phone

(313) 777-7246

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Mustafa Shukr, M.D.

  • Interventional Pain Medicine Physician
  • Dearborn Heights, MI
  • NPI 1952651671
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1781740800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1781740800000",
    "number": "1790611838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23902 FORD RD STE A",
            "city": "DEARBORN HEIGHTS",
            "state": "MI",
            "postal_code": "481273289",
            "telephone_number": "313-777-7246",
            "fax_number": "313-672-6222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23902 FORD RD STE A",
            "city": "DEARBORN HEIGHTS",
            "state": "MI",
            "postal_code": "481273289",
            "telephone_number": "313-777-7246",
            "fax_number": "313-672-6222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REVIVE JOINT AND SPINE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-06-18",
        "last_updated": "2026-06-18",
        "certification_date": "2026-06-18",
        "status": "A",
        "authorized_official_last_name": "SHUKR",
        "authorized_official_first_name": "MUSTAFA",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "313-777-7246",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Interventional Pain Medicine Physician in Dearborn Heights, MI
• Providers in Dearborn Heights, MI by specialty
• Interventional Pain Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.