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MR. STACY DOUGLAS SMITH A.T.,C
NPI 1912262148
Specialist/Technologist - Athletic Trainer in Newark, NJ

Active since July 13, 2012
80 JOHNSON AVE, SHABAZZ, NEWARK, NJ 07108(973) 744-4113 Get Directions Write a Review

NPPES record last updated: June 14, 2016. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Mr. Stacy Douglas Smith A.t.,c NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MR. STACY DOUGLAS SMITH A.T.,C (NPI 1912262148) is an individual athletic trainer provider in Newark, New Jersey, licensed in New Jersey (25MT00037500) and active in the NPI registry since July 2012.

NPPES Registry Identity

NPI1912262148
Entity TypeIndividualMale
Primary Taxonomy2255A2300X
Provider Legal NameMR. STACY DOUGLAS SMITHCredential: A.T.,C
Location Address80 JOHNSON AVE, SHABAZZNewark, NJ 07108
Mailing Address80 Johnson Ave, ShabazzNewark, NJ 07108 · (973) 744-4113
Phone(973) 744-4113
Sole ProprietorYes
Enumeration DateJuly 13, 2012
Last NPPES UpdateJune 14, 2016
✔ NPI 1912262148 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialist/Technologist · Athletic TrainerRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Taxonomy Code2255A2300X
License✔ Licensed in NJ · 25MT00037500
Definition
Athletic trainers are allied health care professionals who work in consultation with or under the direction of physicians, and specialize in the prevention, assessment, treatment and rehabilitation of injuries and illnesses. Currently, the entry-level employment requirements are a bachelor's degree with a major in athletic training from an accredited university or college. A majority of athletic trainers hold advanced degrees. National board certification is generally required as a condition of state licensure and employment. Most states regulate athletic trainers, and they practice within the scope of that license or regulation. Clinical practice includes emergency care, rehabilitation, reconditioning, therapeutic exercise, wellness programs, exercise physiology, kinesiology, biomechanics, nutrition, psychology and health care administration.
80 JOHNSON AVE, Newark, NJ 07108
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Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CENTRAL JERSEY MEDICAL CENTER, INC.
Clinic/Center (Federally Qualified Health Center (FQHC))
80 JOHNSON AVE
NEWARK, NJ 07108
Essex County (973) 623-8592

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Stacy Smith's NPI number?

The NPI number for Stacy Smith is 1912262148. It was assigned to this individual provider in the NPPES registry on July 13, 2012.

Where is Stacy Smith located?

Stacy Smith practices at 80 Johnson Ave Shabazz, Newark, NJ 07108. The listed phone number is (973) 744-4113.

What is Stacy Smith's specialty?

The primary specialty registered for this NPI is Specialist/Technologist, specializing in Athletic Trainer, with taxonomy code 2255A2300X.

When was this NPI record last updated?

The NPPES record for Stacy Smith was last updated on June 14, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.