Jordan Michael Van de Vere, C. PED

Primary specialty

PedorthistTaxonomy code 224L00000X

Practice address

4615 N Lamar Blvd Ste 305
Austin, TX 78751-2357

Phone

(512) 476-5110

Fax

(512) 476-5178

NPI assigned

Jan 20, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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

• Rivercity Footworks, Inc.

  • Durable Medical Equipment & Medical Supplies
  • Austin, TX
  • NPI 1275897142
  NPD (past)

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

{
    "created_epoch": "1611100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611100800000",
    "number": "1467042879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9901 N CAPITAL OF TEXAS HWY STE 120",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787595853",
            "telephone_number": "512-346-4400",
            "fax_number": "512-346-3009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4615 N LAMAR BLVD STE 305",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787512357",
            "telephone_number": "512-476-5110",
            "fax_number": "512-476-5178"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9901 N Capital Of Texas Hwy Ste 120",
            "address_purpose": "LOCATION",
            "city": "Austin",
            "state": "TX",
            "postal_code": "787595853",
            "country_code": "US",
            "telephone_number": "512-346-4400",
            "fax_number": "512-346-3009",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VAN DE VERE",
        "first_name": "JORDAN",
        "middle_name": "MICHAEL",
        "credential": "C. PED",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-01-20",
        "last_updated": "2021-01-20",
        "certification_date": "2021-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224L00000X",
            "taxonomy_group": "",
            "desc": "Pedorthist",
            "state": "TX",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jordan@instepaustin.com",
            "affiliation": "N",
            "endpointDescription": "my work email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "work email",
            "address_1": "9901 N Capital Of Texas Hwy Ste 120",
            "city": "Austin",
            "state": "TX",
            "country_code": "US",
            "postal_code": "787595853",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Roxanne Van Brown, HIS
• Lauren Van Burkleo, SLPA
• Alexandra Bailey Van Cleave
• William C Van de Graaf, MD
• Grace Van de Hoef, SLP
• Annessa Faye Van de Walle, FNP
• Zachary David Van Den Berg, LPC-ASSOCIATE, ATR-P
• Roxane Van Der Lelie, MFT-A
• Christian J. Van Der Schijff, PT, DPT, LAT, ATC
• Tarina Van Der Stockt

• Pedorthist in Austin, TX
• Providers in Austin, TX by specialty
• Pedorthist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2021; 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.