Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MR. STACY DOUGLAS SMITH, A.T.,C
Deactivated Sole ProprietorMR. STACY DOUGLAS SMITH, A.T.,C is a Athletic Trainer healthcare provider located in NEWARK, New Jersey. NPI 1912262148 is deactivated in the NPPES registry. Verify at CMS.
Athletic Trainer · NEWARK, NJ
This NPI has been deactivated.
The record was deactivated on August 10, 2012.
Deactivated NPIs are no longer valid for billing or credentialing. The provider may have retired, changed practice status, or had their NPI administratively deactivated.
Verify current licensure status with the NPPES NPI Registry or the relevant state medical board before relying on this record.
Registration Details
- NPI Number
- 1912262148
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Jul 13, 2012 (0.076712328767123 yrs)
- Last Updated
- Jun 14, 2016
- Deactivated
- Aug 10, 2012
- License
-
25MT00037500 (NJ)
- Sole Proprietor
- Yes
Practice Information
- Address
-
80 JOHNSON AVESHABAZZNEWARK, NJ, 07108Browse NJ providers · Browse ZIP 07108
- Phone
- 9737444113
- Primary Specialty
-
Athletic Trainer
2255A2300X
Other Athletic Trainer Providers in NEWARK, NJ
| Name | Credential | NPI |
|---|---|---|
| COLLEEN C MCCANN | ATC | 1386605103 |
| DANIELLE MARIE COPPOLA | ATC | 1972566362 |
| MARIA LINDA HONORIO | ATC | 1710922547 |
| DONDI BOYD | ATC | 1033146816 |
| MS. MONICA RENE' MATTHEWS | MS, ATC | 1508901869 |
| MR. MARK A DONETZ | ATC | 1457487225 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.