Individual provider Active NPI

Jessica Lynn Bellinger, DC

  • Chiropractor
  • Jacksonville, FL
National Provider Identifier
1407371925
Registry record updated May 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH12126 Issued in FL
Practice address
13453 N Main St Ste 102
Jacksonville, FL 32218-2773
Phone
(904) 854-1004
Fax
(904) 854-1005
NPI assigned
Aug 5, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 25, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH12126 FL Primary

Addresses

Primary practice location

13453 N Main St Ste 102
Jacksonville, FL 32218-2773

Mailing address

381 Palm Coast Pkwy SW Unit 2
Palm Coast, FL 32137-4782
Phone (386) 264-6800

Other practice location 1

381 Palm Coast Pkwy SW Unit 2
Palm Coast, FL 32137-4782
Phone (386) 264-6800

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210624001539 FL Practitioner - Chiropractic 2961803200 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CH12126FLMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Pain Relief Institute LLC CurrentSince Jun 22, 2021 Accepting new patients
Blue Sea Mental Health Practitioners LLC PastSince Nov 17, 2024 Accepting new patients
Davis Chiropractic Center Inc Chiropractor PastSince Aug 1, 2013 Accepting new patients

Locations

4211 N Pearl St
Jacksonville, FL 32206
Phone (904) 358-1159

13453 N Main St
Ste 102
Jacksonville, FL 32218
Phone (904) 358-2225

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": "1501891200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621900800000",
    "number": "1407371925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "381 PALM COAST PKWY SW UNIT 2",
            "city": "PALM COAST",
            "state": "FL",
            "postal_code": "321374782",
            "telephone_number": "386-264-6800",
            "fax_number": "386-264-6802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13453 N MAIN ST STE 102",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322182773",
            "telephone_number": "904-854-1004",
            "fax_number": "904-854-1005"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "381 Palm Coast Pkwy SW Unit 2",
            "address_purpose": "LOCATION",
            "city": "Palm Coast",
            "state": "FL",
            "postal_code": "321374782",
            "country_code": "US",
            "telephone_number": "386-264-6800",
            "fax_number": "386-264-6802",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BELLINGER",
        "first_name": "JESSICA",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-05",
        "last_updated": "2021-05-25",
        "certification_date": "2021-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH12126",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2021; 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.