DR. COURTNEY B FAHNHORST VIDRINE (M.D.) – Undersea and Hyperbaric Medicine (Emergency Medicine) Physician, NPI 1245526466

DR. COURTNEY B FAHNHORST VIDRINE (M.D.) is a healthcare provider. based in Jacksonville, Florida. specializing in FAMILY PRACTICE. They hold the professional credentials M.D.. They hold a License No. ME118350 (FL). The NPI Number for DR. COURTNEY B FAHNHORST VIDRINE (M.D.) is 1245526466

Main info

Female
Sole Proprietor
15 Years Of Experience
Accepts Medicare Assignment
Name
DR. COURTNEY B FAHNHORST VIDRINE (M.D.)
NPI
1245526466
Phone
(904) 396-5682
Address
800 PRUDENTIAL DR STE 713
Enumeration Date
27 June 2011
Last Update Date
13 October 2025

Doctor Profile

Medical School Name
SAINT LOUIS UNIVERSITY SCHOOL OF MEDICINE
Secondary Phone
7278093339
Graduation Year
2011 (15 years ago)
PAC ID
0143449124
Professional Enrollment ID
I20140924001743
Address ID
FL322591155ST205XXWAYX300
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience71
Completeness85
Years active:14State licenses:2Digital endpointsOther names

6,722 FAMILY PRACTICE in FL

Provider Addresses for DR. COURTNEY B FAHNHORST VIDRINE (M.D.)

  • 800 PRUDENTIAL DR STE 713

    JACKSONVILLE, FL 322078202

    Phone: (904) 396-5682

    Fax: (904) 346-0864

    Type: Mailing

  • 101 MARKETSIDE AVE STE 404

    PONTE VEDRA, FL 320811542

    Phone: (904) 410-6040

    Fax: (904) 914-9293

    Type: Mailing

  • 205 TRINITY WAY

    SAINT JOHNS, FL 322591155

    Phone: (904) 410-6040

    Type: Location

  • 800 PRUDENTIAL DR

    JACKSONVILLE, FL 322078202

    Phone: (904) 396-5682

    Fax: (904) 346-0684

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 12 Open Payments records for all available years, with a total value of $412.

Total Amount is formed as General ($412) + Research ($0) + Ownership ($0) = $412.

Last reported payment date: 2024-09-26 • Largest payer in this snapshot: Kerecis Limited ($115).

Total Amount

$412

General + Research + Ownership

Payments

12

Total payment records

General Amount

$412

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-09-26

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2024-12-05

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking 2 Medicare enrollment records; no due dates published yet.

Enrollment records

2

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20140924001743IFamily PracticeFLTBD
I20241205004268IFamily PracticeGATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
11042Removal of skin and tissue, 20.0 sq cm or less392121$0
11045Removal of skin and tissue, each additional 20.0 sq cm or less16925$0
99183Management of oxygen chamber therapy12624$0
97597Removal of tissue from wound, 20.0 sq cm or less11667$0
99213Established patient office or other outpatient visit, 20-29 minutes11269$0
View full utilization report →

Insurance plans in this area (ZIP 32207)

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Reviews

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Frequently asked questions

Is there an official ID for DR. COURTNEY B FAHNHORST VIDRINE (M.D.) in U.S. healthcare records?
The official identifier for DR. COURTNEY B FAHNHORST VIDRINE (M.D.) is NPI 1245526466.
Active or inactive — what applies to DR. COURTNEY B FAHNHORST VIDRINE (M.D.)?
You should see DR. COURTNEY B FAHNHORST VIDRINE (M.D.) as active in CMS-hosted NPPES data.
What kind of doctor is DR. COURTNEY B FAHNHORST VIDRINE (M.D.)?
DR. COURTNEY B FAHNHORST VIDRINE (M.D.) is associated with Undersea and Hyperbaric Medicine (Emergency Medicine) Physician in the directory — Clinical services aligned with this taxonomy classification.
Where in Florida is DR. COURTNEY B FAHNHORST VIDRINE (M.D.) registered?
Use Jacksonville, Florida as the headline location for DR. COURTNEY B FAHNHORST VIDRINE (M.D.) here.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.