Active NPI
Quenitra Q Jackson
- Compounded Sterile Preparations Pharmacist
- Albany, GA
National Provider Identifier
1306700091
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Compounded Sterile Preparations Pharmacist
- License
- RPH035962
- Practice address
- 2715 Dawson Rd
Albany, GA 31707-1673 - Phone
- (229) 606-6508
- NPI assigned
- Dec 16, 2025
- Last updated
- Dec 16, 2025
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Compounded Sterile Preparations Pharmacist | 1835C0207X | RPH035962 | GA | Primary |
Addresses
Primary practice location
2715 Dawson Rd
Albany, GA 31707-1673
Mailing address
80 Dogwood St
Camilla, GA 31730-5373
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
| License | State | Type | Specialty |
|---|---|---|---|
| RPH035962 | GA | MD | Medical license number |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1765843200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1765843200000",
"number": "1306700091",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "80 DOGWOOD ST",
"city": "CAMILLA",
"state": "GA",
"postal_code": "317305373"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2715 DAWSON RD",
"city": "ALBANY",
"state": "GA",
"postal_code": "317071673",
"telephone_number": "229-606-6508"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "QUENITRA",
"middle_name": "Q",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-12-16",
"last_updated": "2025-12-16",
"certification_date": "2025-12-16",
"status": "A"
},
"taxonomies": [
{
"code": "1835C0207X",
"taxonomy_group": "",
"desc": "Pharmacist, Compounded Sterile Preparations",
"state": "GA",
"license": "RPH035962",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Albany, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 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.