Individual provider Active NPI

Landyn Lynn Clark Yudez

  • Physical Therapist
  • Niceville, FL
National Provider Identifier
1780149757
Registry record updated Jun 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT42400 Issued in FL
Practice address
1950 Bluewater Blvd Ste 101
Niceville, FL 32578-3888
Phone
(508) 973-3348
NPI assigned
Feb 4, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT42400 FL Primary

Addresses

Primary practice location

1950 Bluewater Blvd Ste 101
Niceville, FL 32578-3888

Mailing address

1950 Bluewater Blvd Ste 101
Niceville, FL 32578-3888
Phone (508) 973-3348

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241231003658 FL Practitioner - Physical Therapist in Private Practice 1951838044 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT42400FLMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Orthopedic & Sports Physical Therapy Center LLC CurrentSince Jan 6, 2025 Accepting new patients
North Florida Surgeons, PA CurrentSince Jun 1, 2025 Accepting new patients
Orthopedic & Sports Physical Therapy Center LLC CurrentSince Jan 6, 2025 Accepting new patients
North Florida Surgeons, PA CurrentSince Jun 1, 2025 Accepting new patients

Locations

12671 US Highway 98 W
Unit 213
Destin, FL 32550
Phone (850) 650-4186

11945 San Jose Blvd
Ste 300
Jacksonville, FL 32223

11945 San Jose Blvd
Ste 102
Jacksonville, FL 32223
Phone (904) 268-3937

1950 Bluewater Blvd
Ste 101
Niceville, FL 32578
Phone (850) 897-3334

86 Lynn Dr
Santa Rosa Beach, FL 32459
Phone (850) 267-9010

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1549238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750723200000",
    "number": "1780149757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1950 BLUEWATER BLVD STE 101",
            "city": "NICEVILLE",
            "state": "FL",
            "postal_code": "325783888",
            "telephone_number": "508-973-3348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1950 BLUEWATER BLVD STE 101",
            "city": "NICEVILLE",
            "state": "FL",
            "postal_code": "325783888",
            "telephone_number": "508-973-3348"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK YUDEZ",
        "first_name": "LANDYN",
        "middle_name": "LYNN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-04",
        "last_updated": "2025-06-24",
        "certification_date": "2025-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT42400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Niceville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2025; 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.