Active NPI
Jessie James Edgar Jr., PHARMD
- Pharmacist
- Smyrna, GA
National Provider Identifier
1083389043
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PHI-035090
- Practice address
- 200 Technology CT SE
Smyrna, GA 30082-5250 - Phone
- (866) 437-8040
- NPI assigned
- Aug 11, 2021
- Reactivated
- Dec 2, 2025
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | PHI-035090 | GA | Primary |
Addresses
Primary practice location
200 Technology CT SE
Smyrna, GA 30082-5250
Mailing address
619 Myrtle St NE
Atlanta, GA 30308-2431
Phone (229) 291-4128
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PHI-035090 | GA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1628640000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1769126400000",
"number": "1083389043",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "619 MYRTLE ST NE",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303082431",
"telephone_number": "229-291-4128"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 TECHNOLOGY CT SE",
"city": "SMYRNA",
"state": "GA",
"postal_code": "300825250",
"telephone_number": "866-437-8040"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EDGAR",
"first_name": "JESSIE",
"middle_name": "JAMES",
"name_suffix": "Jr.",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-08-11",
"last_updated": "2026-01-23",
"certification_date": "2026-01-23",
"deactivation_date": "2024-08-29",
"reactivation_date": "2025-12-02",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "GA",
"license": "PHI-035090",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Smyrna, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.