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SAVANNAH LANDIS PSYD
NPI 1215598958
Psychologist - Clinical in Jacksonville, FL

Active since June 24, 2019Opted out of Medicare · through Aug 28, 2026
12412 SAN JOSE BLVD, SUITE 304A, JACKSONVILLE, FL 32223(904) 980-8637 Get Directions Write a Review

NPPES record last updated: October 10, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Oct 10, 2024, Aug 28, 2023, Aug 14, 2023 and 1 more (4 updates tracked since 2021).

About Savannah Landis Psyd NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SAVANNAH LANDIS PSYD (NPI 1215598958) is an individual clinical provider in Jacksonville, Florida, licensed in Florida (PY11925) and active in the NPI registry since June 2019. She has opted out of Medicare through August 28, 2026.

NPPES Registry Identity

NPI1215598958
Entity TypeIndividualFemale
Primary Taxonomy103TC0700X
Provider Legal NameSAVANNAH LANDISCredential: PSYD
Location Address12412 SAN JOSE BLVD, SUITE 304AJacksonville, FL 32223
Mailing Address12412 San Jose Blvd, Suite 304Jacksonville, FL 32223 · (904) 980-8637 · Fax (904) 264-2302
Phone(904) 980-8637
Sole ProprietorYes
Enumeration DateJune 24, 2019
Last NPPES UpdateOctober 10, 20244 updates tracked since enumeration
NPPES CertifiedOctober 10, 2024
✔ NPI 1215598958 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code103TC0700X
License✔ Licensed in FL · PY11925
Definition
A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.
12412 SAN JOSE BLVD, Jacksonville, FL 32223
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Savannah Landis Psyd has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from August 28, 2024 through August 28, 2026.

Opt-Out Effective DateAugust 28, 2024
Opt-Out In Effect ThroughAugust 28, 2026Opt-out affidavits renew automatically every two years unless cancelled

Other Providers at the Same Location NPPES 8

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SAMBURSKY CHIROPRACTIC LLC
Chiropractor
12412 SAN JOSE BLVD, 203
JACKSONVILLE, FL 32223
Duval County (904) 683-4376
SARAH DEW-REEVES PH.D.
Psychologist (Clinical Child & Adolescent)
12412 SAN JOSE BLVD, SUITE 203
JACKSONVILLE, FL 32223
Duval County (904) 432-3321
NAUTILUS BEHAVIORAL HEALTH, PLLC
Psychologist (Clinical Child & Adolescent)
12412 SAN JOSE BLVD, SUITE 203
JACKSONVILLE, FL 32223
Duval County (904) 432-3321
STEPHANIE SUMMERS LMFT, P.A.
Marriage & Family Therapist
12412 SAN JOSE BLVD, SUITE 102C
JACKSONVILLE, FL 32223
Duval County (904) 268-9178
UNITY CHIROPRACTIC NEUROLOGY INC
Chiropractor
12412 SAN JOSE BLVD, STE 404
JACKSONVILLE, FL 32223
Duval County (904) 379-6988
UNITY CHIROPRACTIC NEUROLOGY LLC
Chiropractor
12412 SAN JOSE BLVD, SUITE 404
JACKSONVILLE, FL 32223
Duval County (419) 764-3170
DR. BRUCE S SAMBURSKY D.C.
Chiropractor
12412 SAN JOSE BLVD
JACKSONVILLE, FL 32223
Duval County (904) 683-4376
IRENE ELAINE MALESIC MD
Pediatrics
12412 SAN JOSE BLVD, SUITE 104
JACKSONVILLE, FL 32223
Duval County (904) 292-4755

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Savannah Landis's NPI number?

The NPI number for Savannah Landis is 1215598958. It was assigned to this individual provider in the NPPES registry on June 24, 2019.

Where is Savannah Landis located?

Savannah Landis practices at 12412 San Jose Blvd Suite 304A, Jacksonville, FL 32223. The listed phone number is (904) 980-8637.

What is Savannah Landis's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

Is Savannah Landis enrolled in Medicare?

No. Savannah Landis has opted out of Medicare through August 28, 2026. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

When was this NPI record last updated?

The NPPES record for Savannah Landis was last updated on October 10, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 21 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.