Active NPI
Wilton Jackson Jr.
- Pharmacist
- Lumberton, NC
National Provider Identifier
1669847828
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 6276
- Practice address
- 3003 Fayetteville Rd
Walgreens #1056
Lumberton, NC 28358 - Phone
- (910) 739-7072
- NPI assigned
- Dec 14, 2015
- Sex
- Male
- Sole proprietor
- Yes
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 | 6276 | NC | Primary |
Addresses
Primary practice location
3003 Fayetteville Rd
Walgreens #1056
Lumberton, NC 28358
Mailing address
705 N Wilkinson Dr
Saint Pauls, NC 28384-1249
Phone (910) 308-6499
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1450051200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1450051200000",
"number": "1669847828",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "705 N WILKINSON DR",
"city": "SAINT PAULS",
"state": "NC",
"postal_code": "283841249",
"telephone_number": "910-308-6499"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3003 FAYETTEVILLE RD",
"address_2": "WALGREENS #1056",
"city": "LUMBERTON",
"state": "NC",
"postal_code": "28358",
"telephone_number": "910-739-7072"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "WILTON",
"name_suffix": "Jr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2015-12-14",
"last_updated": "2015-12-14",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NC",
"license": "6276",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lumberton, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.