Active NPI
Edward Lawrence Jackson, PHARM.D.
- Pharmacotherapy Pharmacist
- Fort Bragg, NC
National Provider Identifier
1285611707
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacotherapy Pharmacist
- License
- 11096
- Practice address
- Wamc Stop a 2817 Reilly Rd
MCXC PH
Fort Bragg, NC 28310-0001 - Phone
- (910) 907-8680
- Fax
- (910) 907-8443
- NPI assigned
- Dec 27, 2005
- 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 |
|---|---|---|---|---|
| Pharmacotherapy Pharmacist | 1835P1200X | 11096 | NC | Primary |
Addresses
Primary practice location
Wamc Stop a 2817 Reilly Rd
MCXC PH
Fort Bragg, NC 28310-0001
Mailing address
5821 Waldwick Rd
Fayetteville, NC 28311-3413
Phone (910) 488-3349
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 |
|---|---|---|---|
| 11096 | NC | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1135641600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1285611707",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5821 WALDWICK RD",
"city": "FAYETTEVILLE",
"state": "NC",
"postal_code": "283113413",
"telephone_number": "910-488-3349"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "WAMC STOP A 2817 REILLY RD",
"address_2": "MCXC PH",
"city": "FORT BRAGG",
"state": "NC",
"postal_code": "283100001",
"telephone_number": "910-907-8680",
"fax_number": "910-907-8443"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "EDWARD",
"middle_name": "LAWRENCE",
"name_prefix": "Dr.",
"credential": "PHARM.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-12-27",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "1835P1200X",
"taxonomy_group": "",
"desc": "Pharmacist, Pharmacotherapy",
"state": "NC",
"license": "11096",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Bragg, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 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.