Jason W Thackeray MD PA
NPI 1568504173 · Sports Medicine (Orthopaedic Surgery) Physician · Fort Walton Beach, FL
Jason W Thackeray MD PA is a Sports Medicine (Orthopaedic Surgery) Physician organization in Fort Walton Beach, FL (NPI 1568504173).
Provider details
- NPI number
- 1568504173
- Entity type
- Organization
- Primary specialty
- Sports Medicine (Orthopaedic Surgery) PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Jason Thackeray, Physician(850) 863-2153
- License
- ME77615 (FL)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2007-02-12
- Last updated
- 2020-10-29
- Certified
- 2020-10-29
Frequently asked questions
- What is Jason W Thackeray MD PA's NPI number?
- Jason W Thackeray MD PA's National Provider Identifier (NPI) is 1568504173, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Jason W Thackeray MD PA?
- Jason W Thackeray MD PA is classified in the NPPES registry as Sports Medicine (Orthopaedic Surgery) Physician (Allopathic & Osteopathic Physicians).
- Where is Jason W Thackeray MD PA located?
- Jason W Thackeray MD PA's practice location on file with NPPES is 1034 Mar Walt Dr Ste 100, Fort Walton Beach, FL 32547-6645.
- What is Jason W Thackeray MD PA's phone number?
- The practice phone number listed in the NPPES registry for Jason W Thackeray MD PA is (850) 863-2153.
- Who is the authorized official for Jason W Thackeray MD PA?
- The authorized official listed on Jason W Thackeray MD PA's NPPES record is Jason Thackeray, Physician. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Jason W Thackeray MD PA's NPI active?
- Yes — Jason W Thackeray MD PA's NPI (1568504173) is active in the NPPES registry as of the last update on 2020-10-29.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.