=====================================================
General NPI Number Information
=====================================================
NPI Number | 1396628699
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | US PAIN RELIEF PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/26/2025
-----------------------------------------------------
Last Update Date | 07/29/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 5055 PLAINFIELD AVE NE STE C
-----------------------------------------------------
City | GRAND RAPIDS
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 49525-1075
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 616-489-7246
-----------------------------------------------------
Fax | 616-489-1489
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 5055 PLAINFIELD AVE NE STE C
-----------------------------------------------------
City | GRAND RAPIDS
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 49525-1075
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 616-489-7246
-----------------------------------------------------
Fax | 616-489-1489
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CHIEF MEDICAL OFFICER
-----------------------------------------------------
Name | DONALD J BERNARDINI
-----------------------------------------------------
Credential | MD/ANES/PM
-----------------------------------------------------
Telephone | 631-926-8330
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 208VP0014X
-----------------------------------------------------
Taxonomy Name | Interventional Pain Medicine Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------