Revive Pain Solutions Grand Rapids

Primary specialty

Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X

Legal business name

REVIVE PAIN SOLUTIONS GRAND RAPIDS

Practice address

6140 28TH St SE Ste 105
Grand Rapids, MI 49546-6938

Phone

(616) 822-1509

NPI assigned

Jul 14, 2025

Organization subpart

No

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

Authorized official

Name

Dr. Thomas M. Basch, MD

Title

Supervising Physician

Phone

(616) 822-1509

Specialties & licenses 1

Addresses

Other names 1

• Revive Pain Solutions Grand Rapids Doing business as

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

{
    "created_epoch": "1752451200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1760659200000",
    "number": "1962393306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6140 28TH ST SE STE 105",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495466938",
            "telephone_number": "616-901-4218",
            "fax_number": "616-616-7493"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6140 28TH ST SE STE 105",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495466938",
            "telephone_number": "616-822-1509"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REVIVE PAIN SOLUTIONS GRAND RAPIDS",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-07-14",
        "last_updated": "2025-10-17",
        "certification_date": "2025-10-17",
        "status": "A",
        "authorized_official_last_name": "BASCH",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "SUPERVISING PHYSICIAN",
        "authorized_official_telephone_number": "616-822-1509",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208VP0014X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Revive Pain Solutions Grand Rapids",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Retreat Counseling LLC
• Bruce Kevin Retterath, PH.D.
• Angie Ann Rettig
• Kristin Marie Rettig
• Karen Marie Reusch, PT
• Revolution Rehab LLC
• Amanda Joy Rewa, MA, LPC
• Michelle A. Rewa, ACNP
• Christina Rexford, OD
• Diane Rexford, NP

• Interventional Pain Medicine Physician in Grand Rapids, MI
• Providers in Grand Rapids, 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 Oct 17, 2025; 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.