Individual provider Active NPI

Jennifer Lynn Lawrence Jackson, PHARMD

  • Pharmacist
  • Wilmington, DE
National Provider Identifier
1205149382
Registry record updated Jan 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
A1-0004052 Issued in DE
Practice address
4718 Limestone Rd
Wilmington, DE 19808-1928
Phone
(302) 995-2286
NPI assigned
Jul 19, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 28RI04414800 NJ
Pharmacist 183500000X 19643 MD
Pharmacist 183500000X RP459115 PA
Pharmacist 183500000X A1-0004052 DE Primary

Addresses

Primary practice location

4718 Limestone Rd
Wilmington, DE 19808-1928

Mailing address

4718 Limestone Rd
Wilmington, DE 19808-1928
Phone (302) 995-2286

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

LicenseStateTypeSpecialty
A1-0004052DEMDPharmacist
19643MDMDPharmacist
28RI04414800NJMDPharmacist
RP459115PAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Eckerd Corporation PastSince Feb 9, 2020 Accepting new patients
Eckerd Corporation PastSince Feb 9, 2020 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1279497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737936000000",
    "number": "1205149382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4718 LIMESTONE RD",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198081928",
            "telephone_number": "302-995-2286"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4718 LIMESTONE RD",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198081928",
            "telephone_number": "302-995-2286"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "JENNIFER",
        "middle_name": "LYNN LAWRENCE",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-19",
        "last_updated": "2025-01-27",
        "certification_date": "2025-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NJ",
            "license": "28RI04414800",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MD",
            "license": "19643",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "PA",
            "license": "RP459115",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "DE",
            "license": "A1-0004052",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, DE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2025; 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.