GREAT LAKES INTERVENTIONAL PAIN MANAGEMENT,PLLC
NPI 1629447719
Physical Medicine & Rehabilitation - Pain Medicine in Flint, MI

Q: What is Great Lakes Interventional Pain Management,pllc's specialty?

The primary specialty registered for this NPI is Physical Medicine & Rehabilitation, specializing in Pain Medicine, with taxonomy code 2081P2900X.

Active since September 18, 2015CLIA 23D2015468 · Waiver

1311 S LINDEN RD, SUITE A, FLINT, MI 48532(810) 230-1210(810) 230-1225 Get Directions Write a Review

NPPES record last updated: November 17, 2016. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Great Lakes Interventional Pain Management,pllc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

GREAT LAKES INTERVENTIONAL PAIN MANAGEMENT,PLLC (NPI 1629447719) is a healthcare organization registered as a pain medicine in Flint, Michigan and active in the NPI registry since September 2015. The organization holds a CLIA Waiver certificate valid through June 12, 2027 and lists Kavitha Rukkannagari Reddy, Physician, as its authorized official.

NPPES Registry Identity

NPI1629447719

Entity TypeOrganization

Primary Taxonomy2081P2900X

Legal Business NameGREAT LAKES INTERVENTIONAL PAIN MANAGEMENT,PLLC

Location Address1311 S LINDEN RD, SUITE AFlint, MI 48532-3428

Mailing Address1311 S Linden Rd, Suite AFlint, MI 48532-3428 · (810) 230-1210 · Fax (810) 230-1225

Phone(810) 230-1210

Fax(810) 230-1225

Organization SubpartNo

Authorized OfficialKavitha Rukkannagari ReddyPhysician · (810) 410-5148

Enumeration DateSeptember 18, 2015

Last NPPES UpdateNovember 17, 2016

✔ NPI 1629447719 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysical Medicine & Rehabilitation · Pain MedicineAllopathic & Osteopathic Physicians

Taxonomy Code2081P2900X

License✔ Licensed in MI · 4301085040

Definition

A physician who provides a high level of care, either as a primary physician or consultant, for patients experiencing problems with acute, chronic or cancer pain in both hospital and ambulatory settings. Patient care needs may also be coordinated with other specialists.

1311 S LINDEN RD, Flint, MI 48532

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Other Identifiers 3

Medicare UPIN5315020738MI

Other1174515084MI · Npi

Medicaid5353030MI

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health and more.Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 23D2015468

Great Lakes Interventional Pain Management PLLC · Flint, MI

Active · expires Jun 12, 2027

CLIA Number23D2015468

Laboratory TypePhysician Office

Certificate Effective DateJune 13, 2025

Certificate Expiration DateJune 12, 2027

Laboratory DirectorKavitha R. Reddy

Laboratory Phone(810) 230-1210

Laboratory LocationGreat Lakes Interventional Pain Management PLLC1311 S Linden Road Suite A, Flint, MI 48532

CLIA data matches this NPI record on: Address Name Phone

This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ALIGN PHYSICAL THERAPY AND WELLNESS, LLC

Clinic/Center (Physical Therapy)

1311 S LINDEN RD, STE. C
FLINT, MI 48532

Genesee County (810) 836-2078

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Great Lakes Interventional Pain Management,pllc's NPI number?

The NPI number for Great Lakes Interventional Pain Management,pllc is 1629447719. It was assigned to this organization in the NPPES registry on September 18, 2015.

Where is Great Lakes Interventional Pain Management,pllc located?

Great Lakes Interventional Pain Management,pllc is located at 1311 S Linden Rd Suite A, Flint, MI 48532. The listed phone number is (810) 230-1210.

What is Great Lakes Interventional Pain Management,pllc's specialty?

The primary specialty registered for this NPI is Physical Medicine & Rehabilitation, specializing in Pain Medicine, with taxonomy code 2081P2900X.

Does Great Lakes Interventional Pain Management,pllc hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 23D2015468) is associated with this NPI, valid through June 12, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Great Lakes Interventional Pain Management,pllc accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian and Blue Care Network of Michigan list Great Lakes Interventional Pain Management,pllc as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Great Lakes Interventional Pain Management,pllc was last updated on November 17, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.