Individual provider Active NPI

Courtney S Reidy, MD

  • Internal Medicine Physician
  • Jacksonville, FL
National Provider Identifier
1316916265
Registry record updated Jan 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME97574 Issued in FL
Practice address
1200 Riverplace Blvd
Suite 620
Jacksonville, FL 32207-9046
Phone
(904) 396-6620
Fax
(904) 396-6528
NPI assigned
Mar 14, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 01012333389 VA
Hospitalist Physician 208M00000X ME97574 FL
Internal Medicine Physician 207R00000X ME97574 FL Primary

Addresses

Primary practice location

1200 Riverplace Blvd
Suite 620
Jacksonville, FL 32207-9046

Mailing address

1200 Riverplace Blvd
Suite 620
Jacksonville, FL 32207-9046
Phone (904) 396-6620

Other identifiers 3

IdentifierTypeStateIssuer
277376700MedicaidFL
574322629AMedicaidGA
91847OtherFLBCBS

Other names 1

  • Dr. Courtney S Lucado Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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

Enrollment IDStateProvider typePAC IDDetails
I20071215000156 FL Practitioner - Internal Medicine 4486670486 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Eastern Virginia Medical School, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hni Medical Services of Florida, LLCGroup PAC ID 7517202112, 104 clinicians

Practice addresses (Care Compare)

1 Shircliff Way
Jacksonville, FL 32204-4748
Phone (512) 730-3056

Hospital & facility affiliations

  • Ascension St Vincent'S Riverside Hospital, Jacksonville, FL, CCN 100040

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
01012333389VAMDInternal Medicine Physician
ME97574FLMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hni Hospital Services of Florida, LLC Internal Medicine CurrentSince Jan 1, 2025 Accepting new patients
Inpatient Consultants of Florida, Inc Internal Medicine CurrentSince Aug 1, 2008 Accepting new patients
Inpatient Consultants of Florida Inc Internal Medicine CurrentSince Aug 1, 2008 Accepting new patients
Hni Medical Services of Florida, LLC Internal Medicine CurrentSince Aug 1, 2020 Accepting new patients
Emergency Physicians Inc Past Accepting new patients

Locations

900 N Robert Ave
Arcadia, FL 34266
Phone (863) 494-8426

13681 Doctors Way
Fort Myers, FL 33912
Phone (239) 343-1000

4901 Richard St
Jacksonville, FL 32207
Phone (904) 425-0500

4201 Belfort Rd
Jacksonville, FL 32216
Phone (904) 268-5561

1 Shircliff Way
Jacksonville, FL 32204
Phone (904) 332-0414

1200 Riverplace Blvd
Ste 620
Jacksonville, FL 32207
Phone (904) 396-6620

350 7th St N
Naples, FL 34102
Phone (239) 436-5000

401 Palmetto St
New Smyrna Beach, FL 32168
Phone (386) 424-5000

615 N Bonita Ave
Panama City, FL 32401
Phone (850) 747-2020

1700 Tamiami Trl
Sarasota, FL 34239
Phone (941) 917-8507

6000 49th St N
St Petersburg, FL 33709
Phone (727) 521-4411

3030 W Bearss Ave
Tampa, FL 33618
Phone (813) 932-2222

7500 Rialto Blvd
Ste 1-140
Austin, TX 78735

Organizations & group practices 5

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1142294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736899200000",
    "number": "1316916265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 RIVERPLACE BLVD",
            "address_2": "SUITE 620",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322079046",
            "telephone_number": "904-396-6620",
            "fax_number": "904-396-6528"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 RIVERPLACE BLVD",
            "address_2": "SUITE 620",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322079046",
            "telephone_number": "904-396-6620",
            "fax_number": "904-396-6528"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REIDY",
        "first_name": "COURTNEY",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-14",
        "last_updated": "2025-01-15",
        "certification_date": "2025-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "01012333389",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "FL",
            "license": "ME97574",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME97574",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "277376700",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "574322629A",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "91847",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "COURTNEY",
            "last_name": "LUCADO",
            "middle_name": "S",
            "prefix": "DR.",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.