CHARLENE J. JACKSON (PT) – Physical Therapist, NPI 1417073552

CHARLENE J. JACKSON (PT) is a healthcare provider. based in Ashtabula, Ohio. specializing in PHYSICAL THERAPIST IN PRIVATE PRACTICE. They hold the professional credentials PT. They hold a License No. PT01263 (OH). The NPI Number for CHARLENE J. JACKSON (PT) is 1417073552

Main info

Female
54 Years Of Experience
Accepts Medicare Assignment
Name
CHARLENE J. JACKSON (PT)
NPI
1417073552
Phone
(440) 997-5427
Address
416 W 27TH ST
Enumeration Date
21 March 2007
Last Update Date
15 August 2024

Doctor Profile

Medical School Name
OHIO STATE UNIVERSITY COLLEGE OF MEDICINE
Secondary Phone
4409975427
Graduation Year
1972 (54 years ago)
PAC ID
2264695998
Group Practice PAC ID
1850389461
Professional Enrollment ID
I20120516000673
Address ID
OH440044975AS416XXSTXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience62
Completeness75
Years active:19State licenses:1Digital endpointsOther names

2,243 PHYSICAL THERAPIST IN PRIVATE PRACTICE in OH

Provider Addresses for CHARLENE J. JACKSON (PT)

  • 416 W 27TH ST

    ASHTABULA, OH 440044975

    Phone: (440) 997-5427

    Fax: (440) 997-5486

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2012-05-16

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20120516000673IPhysical Therapist In Private PracticeOHTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
97530Therapy procedure using functional activities43479$0
97110Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes25679$0
97112Therapy procedure to re-educate brain-to-nerve-to-muscle function, each 15 minutes24577$0
97140Therapy procedure using manual technique, each 15 minutes10631$0
97162Evaluation for physical therapy, typically 30 minutes1515$0
View full utilization report →

Insurance plans in this area (ZIP 44004)

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Provider's Procedures

CHARLENE J. JACKSON (PT) performs procedures in PHYSICAL THERAPIST IN PRIVATE PRACTICE. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
PHYSICAL THERAPYOH97001Physical therapy evaluation7067
PHYSICAL THERAPYOH97140Manual (physical) therapy techniques to 1 or more regions, each 15 minutes610112

Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 1850389461View full group profile
NameSpecialtyState
-OH
Physical Therapist In Private PracticeOH
Physical Therapist In Private PracticeTN
Physical Therapist In Private PracticeOH
Physical Therapist In Private PracticeOH
Physical Therapist In Private PracticeOH

Reviews

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Frequently asked questions

What number should I use to identify CHARLENE J. JACKSON (PT) for billing?
Administrative and clinical systems typically use NPI 1417073552 for CHARLENE J. JACKSON (PT).
Is CHARLENE J. JACKSON (PT) currently accepting referrals based on NPI status?
Registry metadata lists CHARLENE J. JACKSON (PT) as active.
What does the directory say CHARLENE J. JACKSON (PT) does?
Insurance directories may phrase it differently, but here CHARLENE J. JACKSON (PT) maps to Physical Therapist. Clinical services aligned with this taxonomy classification.
Can patients visit CHARLENE J. JACKSON (PT) in Ashtabula, Ohio?
For routing, start with Ashtabula, Ohio for CHARLENE J. JACKSON (PT), then verify phone and hours locally.
Can I export CHARLENE J. JACKSON (PT)'s record?
You can download the official NPPES record; we summarize key fields for readability.

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