Northeast Florida Wound Cure and Hyperbaric Medicine PLLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

NORTHEAST FLORIDA WOUND CURE AND HYPERBARIC MEDICINE PLLC

Practice address

205 Trinity Way Ste 3800
St Johns, FL 32259-1155

Phone

(612) 310-8971

NPI assigned

Jun 20, 2025

Organization subpart

No

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

Authorized official

Name

Dr. Courtney Blair Fahnhorst Vidrine, MDNPI 1245526466

Title

Ceo

Phone

(612) 310-8971

Specialties & licenses 3

Addresses

Other names 1

• GABLE WOUND CARE AND HYPERBARIC MEDICINE Doing business as

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Courtney B Fahnhorst Vidrine, M.D.

  • Family Medicine Physician
  • Saint Johns, FL
  • NPI 1245526466

  Single Specialty

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1750377600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1787875200000",
    "number": "1568359792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 MARKETSIDE AVE STE 404",
            "city": "PONTE VEDRA",
            "state": "FL",
            "postal_code": "320811542",
            "telephone_number": "612-310-8971"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 TRINITY WAY STE 3800",
            "city": "ST JOHNS",
            "state": "FL",
            "postal_code": "322591155",
            "telephone_number": "612-310-8971"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "250 Duran Dr Ste 101",
            "address_purpose": "LOCATION",
            "city": "St Augustine",
            "state": "FL",
            "postal_code": "320950229",
            "country_code": "US",
            "telephone_number": "904-914-9293",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "13241 Bartram Park Blvd Unit 101",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322585232",
            "country_code": "US",
            "telephone_number": "904-914-9293",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "NORTHEAST FLORIDA WOUND CURE AND HYPERBARIC MEDICINE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-06-20",
        "last_updated": "2026-08-28",
        "certification_date": "2026-08-28",
        "status": "A",
        "authorized_official_last_name": "FAHNHORST VIDRINE",
        "authorized_official_first_name": "COURTNEY",
        "authorized_official_middle_name": "BLAIR",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "612-310-8971",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207PE0005X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Emergency Medicine, Undersea and Hyperbaric Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "GABLE WOUND CARE AND HYPERBARIC MEDICINE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Family Medicine Physician in St Johns, FL
• Providers in St Johns, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.