East Coast Neuro LLC

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

Legal business name

EAST COAST NEURO LLC

Practice address

10550 Deerwood Park Blvd Ste 609a
Jacksonville, FL 32256-2811

Phone

(904) 513-3954

Fax

(904) 212-0223

NPI assigned

Nov 11, 2014

Organization subpart

No

Name

Vanessa Jaclyn WilczakNPI 1366775124

Title

Owner and Authorized Official

Phone

(904) 513-3954

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

• Anna Manelis, DPT, PH.D.

  • Physical Therapist
  • Jacksonville, FL
  • NPI 1780498071

  FL, Physical Therapist

  Medicare reassignment Care Compare group NPD
• Chelsea L Toldi, P.T.

  • Physical Therapist
  • Lakewood Ranch, FL
  • NPI 1851787790

  FL, Physical Therapist

  Medicare reassignment Care Compare group NPD
• Vanessa Jaclyn Wilczak, D.C.

  • Chiropractor
  • Jacksonville, FL
  • NPI 1366775124

  FL

  Medicare reassignment NPD Authorized official
• Gregory McNamara, MD

  • Internal Medicine Physician
  • Jacksonville, FL
  • NPI 1720051832

  FL

  Medicare reassignment Care Compare group
• Emily Ford, APRN

  • Nurse Practitioner
  • Jacksonville, FL
  • NPI 1861887770

  FL

  Medicare reassignment NPD
• Renu Gautam, MD

  • Family Medicine Physician
  • Jacksonville, FL
  • NPI 1558744417

  FL

  Medicare reassignment NPD
• Craig A Cherrin, ARNP

  • Nurse Practitioner
  • Jacksonville, FL
  • NPI 1194267625

  FL

  Medicare reassignment
• Adam James Whalen, D.C.

  • Chiropractor
  • Jacksonville, FL
  • NPI 1396067963

  FL

  Medicare reassignment
• Catherine A Yelvington, PT

  • Physical Therapist
  • Jacksonville, FL
  • NPI 1023163912

  FL

  Medicare reassignment
• Harsh Trikambhai Dangaria, M.D.

  • Pain Medicine Physician
  • Saint Marys, GA
  • NPI 1861789992

  FL

  Medicare reassignment
• Jasmine Bentley, PTA

  • Physical Therapy Assistant
  • Jacksonville, FL
  • NPI 1306661947
  NPD
• Lindsey Dell

  • Physical Therapy Assistant
  • Jacksonville, FL
  • NPI 1013614700
  NPD

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Vjwdc, Inc

  • Physical Therapist
  • Jacksonville, FL
  • NPI 1578223764

  Member Of

  NPD member

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/20866/brand/1/csg/1/fhir/r4

• East Coast Injury Clinic Doing business as

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jan 22, 2026.

{
    "created_epoch": "1415664000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1769040000000",
    "number": "1124424643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 936957",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "311936957",
            "telephone_number": "941-209-5410",
            "fax_number": "941-209-5652"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10550 DEERWOOD PARK BLVD STE 609A",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322562811",
            "telephone_number": "904-513-3954",
            "fax_number": "904-212-0223"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13453 N Main St Ste 302",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322182773",
            "country_code": "US",
            "telephone_number": "904-513-3954",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "EAST COAST NEURO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-11-11",
        "last_updated": "2026-01-22",
        "certification_date": "2026-01-22",
        "status": "A",
        "authorized_official_last_name": "WILCZAK",
        "authorized_official_first_name": "VANESSA",
        "authorized_official_middle_name": "JACLYN",
        "authorized_official_title_or_position": "OWNER AND AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "904-513-3954"
    },
    "taxonomies": [
        {
            "code": "111NN0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor, Neurology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "East Coast Injury Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Earthly Stars, LLC
• Megan Elizabeth Easley
• East Coast Cardiology PA
• East Coast Compounding & Pharmacy, LLC
• East Coast Institute for Research, LLC
• Lara Ashley East Laneve, PA-C
• Carly Easterday
• Elizabeth Easterly, LPN
• Zowie Eastman
• Shantoria Easton, PHARMD

• All providers in Jacksonville, FL
• Neurology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.