JACK R. STACEY, III M.D. – NPI #1700317591
Family Medicine

A family medicine physician that is trained to be responsible for continuous care in the field of sports medicine, not only for the enhancement of health and fitness, but also for the prevention of injury and illness. A sports medicine physician must have knowledge and experience in the promotion of wellness and the prevention of injury. Knowledge about special areas of medicine such as exercise physiology, biomechanics, nutrition, psychology, physical rehabilitation, epidemiology, physical evaluation, injuries (treatment and prevention and referral practice) and the role of exercise in promoting a healthy lifestyle are essential to the practice of sports medicine. The sports medicine physician requires special education to provide the knowledge to improve the health care of the individual engaged in physical exercise (sports) whether as an individual or in team participation.

JACK STACEY, III is a physician located in OCEANSIDE, CA. NPPES has assigned the NPI number 1700317591 to JACK STACEY, III on March 23, 2017. It is a Type-1 NPI, indicating this NPI number is associated with an individual. The primary taxonomy selected by this provider is 207QS0010X from the Health Care Provider Taxonomy code set, which is classified as Family Medicine, specializing in Sports Medicine

The NPI profile was last updated on Feb 06, 2025. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for JACK STACEY, III below.

NPI Profile for
JACK R. STACEY, III

NPI Number
1700317591
Enumeration Date

(more than 9 years ago)
Entity Type
Type-1  Individual (Male)
Legal Name
JACK R. STACEY, III
Credentials
M.D.
Primary location
200 MERCY CIRCLE
OCEANSIDE, CA 92055
Phone: (760) 725-0456 Fax:
Mailing address
2616 CABRILLO PL
CARLSBAD, CA 92008-1436
Phone: (321) 278-3667 Fax:
Sole Proprietor
No
Updated
Certification Date
Feb 03, 2025

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
207QS0010X
- Family Medicine / Sports Medicine (Primary)
VA 0101271348

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.