DR. VANESSA JACLYN WILCZAK (NPI# 1366775124) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366775124 |
| Entity Type | Individual |
| Full Name | DR. VANESSA JACLYN WILCZAK |
| Credential | D.C. |
| Practice Address |
1564 Kingsley Ave Clay Pain Center Orange Park FL 32073-4511 |
| Mailing Address |
4831 Florida Club Cir Apt 2203 Jacksonville FL 32216-1088 |
| Practice Telephone | 9042640400 |
| Practice Fax Number | 9042640401 |
| Mailing Telephone | 9042640400 |
| Mailing Fax Number | 9042640401 |
| Enumeration Date | 2009-09-11 |
| Last Update Date | 2009-09-11 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 111N00000X | Chiropractor | 2009008265 | MO | Chiropractic Providers |
| N | 111N00000X | Chiropractor | X011698 | NY | Chiropractic Providers |
| Y | 111N00000X | Chiropractor | CH9776 | FL | Chiropractic Providers |
| Street Address |
1564 KINGSLEY AVE CLAY PAIN CENTER |
| City | ORANGE PARK |
| State | FL |
| Zip Code | 32073-4511 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326025321 | Pain and Rehabilitation Network Inc | Clinic/Center | 1564 Kingsley Ave, Orange Park, FL 32073-4511 | 2005-12-30 |
| 1245792605 | Aaron Mcclure Do LLC | Anesthesiology | 1564 Kingsley Ave, Orange Park, FL 32073-4521 | 2019-04-04 |
| 1558814152 | Julia Brooke Davis | Physical Therapist | 1564 Kingsley Ave, Suite 200, Orange Park, FL 32073-4521 | 2016-07-31 |
| 1164801767 | Physicians Group Services, Pa | Anesthesiology | 1564 Kingsley Ave, Orange Park, FL 32073-4521 | 2015-05-28 |
| 1669714929 | Carol G Wilkinson | Nurse Anesthetist, Certified Registered | 1564 Kingsley Ave, Orange Park, FL 32073-4521 | 2013-03-25 |
| 1013291517 | Medical Partners of Jacksonville LLC | Pain Medicine | 1564 Kingsley Ave, Orange Park, FL 32073-4511 | 2011-10-03 |
| 1275763872 | Hilary Manees | Physical Therapist | 1564 Kingsley Ave, Suite 200, Orange Park, FL 32073-4521 | 2009-07-17 |
| 1659508273 | Clay Pain Center Physicians LLC | Pain Medicine | 1564 Kingsley Ave, Orange Park, FL 32073-4511 | 2009-06-22 |
| 1174758825 | Abcn Pain Management LLC | Pain Medicine | 1564 Kingsley Ave, Orange Park, FL 32073-4511 | 2009-05-26 |
| 1851526511 | Fccn Pain Management LLC | Pain Medicine | 1564 Kingsley Ave, Orange Park, FL 32073-4511 | 2009-05-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891309423 | Kingsley Endoscopy Center LLC | Clinic/Center | 970 Kingsley Avenue, Orange Park, FL 32073 | 2020-09-01 |
| 1962028688 | Esra Sari | Student in an Organized Health Care Education/Training Program | 2001 Kingsley Avenue., Orange Park Medical Center, Orange Park, FL 32073 | 2020-06-18 |
| 1104441146 | Zeshan Tariq Malik | Student in an Organized Health Care Education/Training Program | 2001 Kingsley Avenue, Office of Graduate Medical Educa, Orange Park, FL 32073 | 2020-06-16 |
| 1902421894 | Ameer Hamza | Student in an Organized Health Care Education/Training Program | 2001, Kingsley Avenue Office of Graduate Medical Educat, Orange Park, FL 32073 | 2020-06-16 |
| 1497378103 | Fawad Ahmed Rashid | Student in an Organized Health Care Education/Training Program | 2001 Kingsley Avenue Office of Graduate Medical Educati, Orange Park, FL 32073 | 2020-05-28 |
| 1477174985 | Hannan Asghar | Student in an Organized Health Care Education/Training Program | Office of Graduate Medical Education 2001 Kingsley, Orange Park, FL 32073 | 2020-05-06 |
| 1902427156 | Emmanuel Iyanuloluwa Morakinyo | Student in an Organized Health Care Education/Training Program | 413 Deer View Avenue, 2001 Kingsley Ave, Orange Park, FL 32073 | 2020-04-29 |
| 1437799327 | Dalande Leger | Behavior Technician | 1563 Kingsley Ave Suite 103, Orange Park, FL 32073 | 2020-01-08 |
| 1215598313 | Mohammad Harisullah Khan | Student in an Organized Health Care Education/Training Program | 2001 Kingsley Ave, Gme Office, Orange Park, FL 32073 | 2019-06-28 |
| 1558927970 | Preetha Kamath | Student in an Organized Health Care Education/Training Program | Orange Park Medical Center, 2001 Kingsley Ave, Orange Park, FL 32073 | 2019-05-10 |
| Find all providers in zip 32073 | ||||
| Taxonomy Code | 111N00000X |
| Grouping | Chiropractic Providers |
| Classification | Chiropractor |
| A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972154896 | Acuna Medical LLC | Chiropractor | 1211 Blanding Blvd, Orange Park, FL 32065-7315 | 2019-09-23 |
| 1144609900 | Jns Physicians Group LLC | Chiropractor | 1724 Village Way Ste B, Orange Park, FL 32073-5225 | 2015-05-27 |
| 1952732281 | Natasha Kae Musser | Chiropractor | 410 Blanding Blvd Ste 7, Orange Park, FL 32073-5065 | 2013-12-12 |
| 1154624625 | Jacksonville Injury & Rehab | Chiropractor | 859 Park Ave, Suite 102, Orange Park, FL 32073-4187 | 2010-12-06 |
| 1316140817 | Randy John | Chiropractor | 35 Knight Boxx Rd, Suite 3, Orange Park, FL 32065-8053 | 2007-06-11 |
| 1346459021 | Staci Lynn Bracken | Chiropractor | 461 Kingsley Ave, Orange Park, FL 32073-4827 | 2007-05-21 |
| 1407072242 | Musa Chiropractic & Wellness Center Inc | Chiropractor | 1915 East West Pkwy Ste 1, Orange Park, FL 32003-6350 | 2007-04-18 |
| 1922142405 | John David Moore | Chiropractor | 752 Blanding Blvd Ste 2, Orange Park, FL 32065-5790 | 2007-02-16 |
| 1992860811 | Mary Ann Musa | Chiropractor | 1915-2 East West Parkway, Orange Park, FL 32003-4908 | 2006-12-22 |
| 1306917786 | Gordon B Garver | Chiropractor | 418 Kingsley Ave, Orange Park, FL 32073-4828 | 2006-11-10 |
| Find all providers in ORANGE PARK | ||||
| City | ORANGE PARK |
| Zip Code | 32073 |
Please comment or provide details below to improve the information on DR. VANESSA JACLYN WILCZAK.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.