Charlene J. Jackson, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT01263 Issued in OH

Practice address

416 W 27TH St
Ashtabula, OH 44004-4975

Phone

(440) 997-5427

Fax

(440) 997-5486

NPI assigned

Mar 21, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Ohio State University College of Medicine, 1972

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Seeds Orthopaedics, Inc.Group PAC ID 1850389461, 6 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Seeds Orthopaedics, Inc

  • Orthopaedic Surgery Physician
  • Ashtabula, OH
  • NPI 1023010881
  Medicare reassignment Care Compare group NPD
• All Star Physical Therapy Inc

  • Physical Therapist
  • Ashtabula, OH
  • NPI 1124347737
  NPD (past)

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

{
    "created_epoch": "1174435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723680000000",
    "number": "1417073552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "416 W 27TH ST",
            "city": "ASHTABULA",
            "state": "OH",
            "postal_code": "440044975",
            "telephone_number": "440-997-5427",
            "fax_number": "440-997-5486"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "416 W 27TH ST",
            "city": "ASHTABULA",
            "state": "OH",
            "postal_code": "440044975",
            "telephone_number": "440-997-5427",
            "fax_number": "440-997-5486"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "CHARLENE",
        "middle_name": "J.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-21",
        "last_updated": "2024-08-15",
        "certification_date": "2024-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OH",
            "license": "PT01263",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0747777",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Inertia Massage Therapy,LLC
• Bethany Ellen Irish, CRNA
• Linda Joi Isenberg
• Travis Isenberg, PHARMD
• Casey Iverson
• Robin Suzette Jackson
• Travis Carson Jackson
• Vanessa Micheline Jackson
• Ellen H Jacobs, MSW, LISW, DCSW
• Maureen Denise Jacobson, R.D. , L.D.

• Physical Therapist in Ashtabula, OH
• Providers in Ashtabula, OH by specialty
• Physical Therapist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2024; 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.