JESSICA LYNNE CHARLES (DC) – Chiropractor, NPI 1104405497

JESSICA LYNNE CHARLES (DC) is a healthcare provider. based in Dallas, Texas. specializing in CHIROPRACTIC. They hold the professional credentials DC. They hold a License No. 14611 (TX). The NPI Number for JESSICA LYNNE CHARLES (DC) is 1104405497

Main info

Female
9 Years Of Experience
Accepts Medicare Assignment
Name
JESSICA LYNNE CHARLES (DC)
NPI
1104405497
Phone
Not provided
Address
4801 S BUCKNER BLVD STE 200
Enumeration Date
5 April 2021
Last Update Date
5 April 2021

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6824051934
Graduation Year
2017 (9 years ago)
PAC ID
2163926981
Group Practice PAC ID
3779924048
Professional Enrollment ID
I20250916002225
Address ID
TX751152388DE1534XRDXX501
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience34
Completeness75
Years active:5State licenses:1Digital endpointsOther names

2,110 CHIROPRACTIC in TX

Provider Addresses for JESSICA LYNNE CHARLES (DC)

  • 4801 S BUCKNER BLVD STE 200

    DALLAS, TX 752272372

    Phone:

    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: 2025-09-16

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
I20250916002225IChiropracticTXTBD

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 75227)

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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: 3779924048View full group profile
NameSpecialtyState
Nurse PractitionerTX
Nurse PractitionerTX

Reviews

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Frequently asked questions

What is JESSICA LYNNE CHARLES (DC)'s NPI number?
JESSICA LYNNE CHARLES (DC)'s NPI is 1104405497 — the number used across U.S. healthcare to identify this provider.
Would JESSICA LYNNE CHARLES (DC) appear as active to a payer?
You can treat JESSICA LYNNE CHARLES (DC) as active for directory purposes; confirm clinical privileges separately.
What expertise is attributed to JESSICA LYNNE CHARLES (DC)?
JESSICA LYNNE CHARLES (DC)'s specialty line reads Chiropractor. Clinical services aligned with this taxonomy classification.
Is JESSICA LYNNE CHARLES (DC) located near Dallas?
JESSICA LYNNE CHARLES (DC) currently maps to Dallas, Texas in this extract.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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