Individual provider Active NPI

Edwina L Jones

  • Pharmacist
  • Lawrenceville, GA
National Provider Identifier
1154060176
Registry record updated May 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
019776 Issued in GA
Practice address
1430 Azalea Brook Dr
Lawrenceville, GA 30043-3300
Phone
(678) 377-9127
NPI assigned
May 27, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 27, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 019776 GA Primary

Addresses

Primary practice location

1430 Azalea Brook Dr
Lawrenceville, GA 30043-3300

Mailing address

1430 Azalea Brook Dr
Lawrenceville, GA 30043-3300
Phone (678) 377-9127

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address Edwina.Jones@ejsportspharmacy.com Direct

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

State licenses

LicenseStateTypeSpecialty
019776GAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1653609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653609600000",
    "number": "1154060176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1430 AZALEA BROOK DR",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300433300",
            "telephone_number": "678-377-9127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1430 AZALEA BROOK DR",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300433300",
            "telephone_number": "678-377-9127"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JONES",
        "first_name": "EDWINA",
        "middle_name": "L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-05-27",
        "last_updated": "2022-05-27",
        "certification_date": "2022-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "GA",
            "license": "019776",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Edwina.Jones@ejsportspharmacy.com",
            "affiliation": "N",
            "endpointDescription": "Business Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1430 Azalea Brook Dr",
            "city": "Lawrenceville",
            "state": "GA",
            "country_code": "US",
            "postal_code": "300433300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lawrenceville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.