David Macy Vidrine, M.D.

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

License

109818 Issued in GA

Practice address

80 Lacy St NW
Marietta, GA 30060-1112

Phone

(770) 427-0368

Fax

(678) 581-5969

NPI assigned

Jun 13, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 2

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in SC, GA, FL3 enrollments

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 3

Specialty

OtolaryngologyAlso: Allergy/Immunology

Education

Louisiana State University School of Medicine in New Orleans, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

South Carolina ENT Allergy and Sleep Medicine PAGroup PAC ID 0840214748, 24 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: dvidrine380160@direct.musc.edu
• Direct secure messaging: scent@allmedsdirectmail.com
• Direct secure messaging: david.vidrine@scent.emadirect.md

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.

• South Carolina ENT Allergy & Sleep Medicine PA

  • Otolaryngology Physician
  • Lugoff, SC
  • NPI 1134153083
  Medicare reassignment Care Compare group NPD
• Northwest ENT Associates, PC

  • Otolaryngology/Facial Plastic Surgery Physician
  • Marietta, GA
  • NPI 1821176967
  Medicare reassignment NPD (past)
• Advanced ENT and Allergy PLLC

  • Otolaryngology Physician
  • Louisville, KY
  • NPI 1780817502
  NPD (past)
• Randolph Health Systems, LLC

  • General Acute Care Hospital
  • Roanoke, AL
  • NPI 1194892257
  NPD (past)
• Wedowee Hospital

  • Rural Health Clinic/Center
  • Wadley, AL
  • NPI 1467597146
  NPD (past)

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

{
    "created_epoch": "1150156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784246400000",
    "number": "1447293121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 23781",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100873781",
            "telephone_number": "770-427-0368",
            "fax_number": "678-581-5969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 LACY ST NW",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300601112",
            "telephone_number": "770-427-0368",
            "fax_number": "678-581-5969"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1600 Lakeland Hills Blvd",
            "address_purpose": "LOCATION",
            "city": "Lakeland",
            "state": "FL",
            "postal_code": "338053019",
            "country_code": "US",
            "telephone_number": "863-680-7000",
            "fax_number": "866-264-8519",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VIDRINE",
        "first_name": "DAVID",
        "middle_name": "MACY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-13",
        "last_updated": "2026-07-17",
        "certification_date": "2026-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207YP0228X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Pediatric Otolaryngology",
            "state": "SC",
            "license": "30117",
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "GA",
            "license": "109818",
            "primary": true
        },
        {
            "code": "207YP0228X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Pediatric Otolaryngology",
            "state": "MA",
            "license": "226983",
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "FL",
            "license": "ME181268",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "301177",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNSPECIFIED",
            "identifier": "DE5192",
            "state": "SC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dvidrine28928@direct.watsonclinicad.com",
            "affiliation": "Y",
            "endpointDescription": "Direct Messaging Address",
            "affiliationName": "Watson Clinic LLP",
            "address_1": "1430 Lakeland Hills Blvd",
            "city": "Lakeland",
            "state": "FL",
            "country_code": "US",
            "postal_code": "338053202",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "SCENT@allmedsdirectmail.com",
            "affiliation": "N",
            "address_1": "15 Exchange Dr",
            "city": "Lugoff",
            "state": "SC",
            "country_code": "US",
            "postal_code": "290789198",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Sara Cassella Videtto, MS, MA, CCC-SLP
• Cory Viehl, PHD
• Matthew Vieron
• Hayley Vietti, DO
• Village Autism Center LLC
• Village Podiatry Group LLC

• Otolaryngology Physician in Marietta, GA
• Providers in Marietta, GA by specialty
• Otolaryngology Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2026; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.