Jesse William Vredenburgh, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

J1804 Issued in TX

Practice address

24624 Interstate 45 N Ste 125
Spring, TX 77386-4084

Phone

(832) 688-6111

Fax

(832) 365-6132

NPI assigned

Jan 10, 2007

Last updated

Jan 29, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Galleria Pain Physicians PLLC

  • Pain Medicine Physician
  • Webster, TX
  • NPI 1972002038

  General Practice

  Medicare reassignment NPD
• Woodlands Health Group, PLLC

  • Physical Medicine & Rehabilitation Physician
  • Spring, TX
  • NPI 1902389521
  Medicare reassignment NPD
• Woodlands Health Group, PLLC

  • Durable Medical Equipment & Medical Supplies
  • Spring, TX
  • NPI 1811537699
  NPD
• Deming Hospital Corporation

  dba Mimbres Memorial Hosp - Anest & Pain Mgt

  • Pain Medicine (Anesthesiology) Physician
  • Deming, NM
  • NPI 1386850519
  NPD (past)
• Direct Health Medical Center Inc

  dba San Diego Spine & Rehab Inc

  • Physical Medicine & Rehabilitation Physician
  • San Diego, CA
  • NPI 1376744649

  Family Medicine

  NPD (past)

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

{
    "created_epoch": "1168387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611878400000",
    "number": "1174673685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "745 KINGS POINT HBR",
            "city": "CORPUS CHRISTI",
            "state": "TX",
            "postal_code": "784021713",
            "telephone_number": "361-563-4325",
            "fax_number": "361-880-4096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24624 INTERSTATE 45 N STE 125",
            "city": "SPRING",
            "state": "TX",
            "postal_code": "773864084",
            "telephone_number": "832-688-6111",
            "fax_number": "832-365-6132"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VREDENBURGH",
        "first_name": "JESSE",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-10",
        "last_updated": "2021-01-29",
        "certification_date": "2021-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "J1804",
            "primary": true
        },
        {
            "code": "2083X0100X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Occupational Medicine",
            "state": "TX",
            "license": "J1804",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "TX",
            "license": "J1804",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cavy Vo
• Dai Tran Vo, RPH
• Leyna Thanh Vo, PHARMD
• Stacy Thi Vo, PHARM D
• Virginie T Vo, FNP
• Kim Anh Vu, PA-C
• Stephanie L Vu, DDS
• Vy Khanh Vu, PHARMD
• Jennifer Renee Wade, PHARMD
• Karen Wade, MT-BC

• Family Medicine Physician in Spring, TX
• Providers in Spring, TX by specialty
• Family Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.