Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Revitalize Pain and Spine LLC

Organization Specialist · NPI 1346848090

Revitalize Pain and Spine LLC is a Specialist in Mesa, Arizona. Registered with an NPI since 2020.

In the registry since
2020
Specialties on file
5
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

4838 E Baseline Rd Ste 110
Mesa, AZ 85206-4674
Phone: (480) 210-2641
Fax: (480) 210-2642
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pain Medicine Physician (primary) Taxonomy 208VP0000X
Specialist Taxonomy 174400000X
Pain Medicine (Anesthesiology) Physician Taxonomy 207LP2900X
Interventional Pain Medicine Physician Taxonomy 208VP0014X
Nurse Practitioner Taxonomy 363L00000X

Record details

NPI number1346848090
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Amy Williams — Director · (480) 969-4040
NPI enumeratedOctober 14, 2020
Last updated in NPPESOctober 14, 2020
Certification dateOctober 14, 2020
Mailing address4838 E Baseline Rd Ste 110, Mesa, AZ 85206-4674

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