Individual provider Active NPI

Ronald Fred Stacey II, D.C.

  • Chiropractor
  • Trinity, FL
National Provider Identifier
1285658104
Registry record updated Dec 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH9214 Issued in FL
Practice address
8142 Bellarus Way Ste 104
Trinity, FL 34655-1799
Phone
(727) 202-1303
Fax
(727) 835-7955
NPI assigned
Jul 26, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 5, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH9214 FL Primary

Addresses

Primary practice location

8142 Bellarus Way Ste 104
Trinity, FL 34655-1799

Mailing address

8142 Bellarus Way Ste 104
Trinity, FL 34655-1799
Phone (727) 202-1303

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070614000595 FL Practitioner - Chiropractic 2264530237 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CH9214FLMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
After Care Center of Florida at Holiday LLC Chiropractor CurrentSince Oct 6, 2018 Accepting new patients
Vaxonsite, LLC PastSince Feb 28, 2017 Accepting new patients
Palm Harbor Chiropractic and Rehabilitation Clinic, Inc. PastSince May 21, 2015 Accepting new patients
Neuro-Stat PastSince Oct 6, 2018 Accepting new patients
Coastal Chiropractic and Rehab Chiropractor Past Accepting new patients

Locations

8142 Bellarus Way
Ste 104
Trinity, FL 34655
Phone (727) 202-1303

Interoperability endpoints

  • Direct secure messaging: ronaldstacey@tsc.allscriptsdirect.net

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670198400000",
    "number": "1285658104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8142 BELLARUS WAY STE 104",
            "city": "TRINITY",
            "state": "FL",
            "postal_code": "346551799",
            "telephone_number": "727-202-1303",
            "fax_number": "727-835-7955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8142 BELLARUS WAY STE 104",
            "city": "TRINITY",
            "state": "FL",
            "postal_code": "346551799",
            "telephone_number": "727-202-1303",
            "fax_number": "727-835-7955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STACEY",
        "first_name": "RONALD",
        "middle_name": "FRED",
        "name_prefix": "Dr.",
        "name_suffix": "II",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-26",
        "last_updated": "2022-12-05",
        "certification_date": "2022-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH9214",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Trinity, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.