BUCK JACK LLC (NPI# 1083212393) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083212393 |
| Entity Type | Organization |
| Organization Name | BUCK JACK LLC |
| Practice Address |
Mountain View Core Knowledge School 890 Field Ave Cannon City CO 81212 |
| Mailing Address |
685 Citadel Dr E Ste 580 Colorado Springs CO 80909-5381 |
| Practice Telephone | 7195970822 |
| Practice Fax Number | 7195994606 |
| Mailing Telephone | 7195970822 |
| Mailing Fax Number | 7195994606 |
| Enumeration Date | 2020-10-09 |
| Last Update Date | 2020-10-09 |
| Authorized Official Name | REBECCA NEWMAN (BILLING MANAGER) |
| Authorized Official Telephone | 7195970822 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 225100000X | Physical Therapist | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | ||
| N | 235Z00000X | Speech-Language Pathologist | Speech, Language and Hearing Service Providers | ||
| Y | 225X00000X | Occupational Therapist | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Other Name | Type Code |
|---|---|
| THE SHANDY CLINIC | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912505116 | Buck Jack LLC | Behavioral Analyst | 1301 Fortino Blvd, Pueblo, CO 81008-2032 | 2020-10-12 |
| 1376141572 | Buck Jack LLC | Behavioral Analyst | 1321 S Prairie Ave, Pueblo, CO 81005-2307 | 2020-10-12 |
| 1568060754 | Buck Jack LLC | Behavioral Analyst | 830 Tenderfoot Hill Rd Ste 100, Colorado Springs, CO 80906-7372 | 2020-10-12 |
| 1730787920 | Buck Jack LLC | Behavioral Analyst | 917 E Moreno Ave Ste 150, Colorado Springs, CO 80903-4547 | 2020-10-12 |
| 1467050658 | Buck Jack LLC | Behavioral Analyst | 901 N Santa Fe Ave, Fountain, CO 80817-1738 | 2020-10-12 |
| 1104424423 | Buck Jack LLC | Behavioral Analyst | 3625 Citadel Dr S, Colorado Springs, CO 80909-5320 | 2020-10-09 |
| 1497353700 | Buck Jack LLC | Physical Therapist | 2233 Academy Pl Ste 201, Colorado Springs, CO 80909-1679 | 2020-10-09 |
| 1942808258 | Buck Jack LLC | Behavioral Analyst | 8540 Scarborough Dr Ste 300, Colorado Springs, CO 80920-7519 | 2020-10-09 |
| 1619575909 | Buck Jack LLC | Physical Therapist | 3901 E Yale Ave, Denver, CO 80210-6646 | 2020-10-09 |
| 1174121487 | Buck Jack LLC | Behavioral Analyst | 17230 Jackson Creek Pkwy Ste 220, Monument, CO 80132-7304 | 2020-10-09 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Colorado Business Entities | Buck Jack LLC | 419 South Tejon Appt. 309, Colorado Springs, CO 80903 |
| Street Address |
MOUNTAIN VIEW CORE KNOWLEDGE SCHOOL 890 FIELD AVE |
| City | CANNON CITY |
| State | CO |
| Zip Code | 81212 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942841374 | Glorious Works Neurotherapy | Community/Behavioral Health | 115 N 7th Street, Canon City, CO 81212 | 2019-10-07 |
| 1376046292 | Lonnie Mccarron | Social Worker | 600 Evans Rd, Fremont Correctional Facility, Canon City, CO 81212 | 2018-03-16 |
| 1487156964 | Patrick Neil Cox | Case Manager/Care Coordinator | 3239 Independence Road, Canon City, CO 81212 | 2018-03-01 |
| 1831559806 | Justin Ensinger | Counselor | 700 Four Mile Parkway, Canon City, CO 81212 | 2016-03-03 |
| 1710365713 | Amber Conover | Health Educator | 105 N 10th Street, Canon City, CO 81212 | 2015-05-11 |
| 1902073448 | Richard R Williams | Counselor | 612 Field Ave, Canon City, CO 81212 | 2008-05-14 |
| 1861662249 | Huh Inc | Hearing Instrument Specialist | 121 Justice Center Rd Ste D, Canon City, CO 81212 | 2008-03-03 |
| 1013113828 | Deborah Eileen Shock | Nurse Practitioner | 275 W Hwy 50, Canon City, CO 81212 | 2007-06-27 |
| 1245433564 | Lindsey Elizabeth Fish | Internal Medicine | 275 West Hwy 50, Colorado Territorial Correctional Facility, Canon City, CO 81212 | 2007-06-06 |
| 1891913869 | Safe Watch, Inc. | Home Health | 815 Garden Park Rd, Canon City, CO 81212 | 2007-04-23 |
| Find all providers in zip 81212 | ||||
| Taxonomy Code | 225X00000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Occupational Therapist |
| An occupational therapist is a person who has graduated from an entry-level occupational therapy program accredited by the Accreditation Council for Occupational Therapy Education (ACOTE) or predecessor organizations, or approved by the World Federation of Occupational Therapists (WFOT), or an equivalent international occupational therapy education program; has successfully completed a period of supervised fieldwork experience required by the occupational therapy program; has passed a nationally recognized entry-level examination for occupational therapists, and fulfills state requirements for licensure, certification, or registration. An occupational therapist provides interventions based on evaluation and which emphasize the therapeutic use of everyday life activities (i.e., occupations) with individuals or groups for the purpose of facilitating participation in roles and situations and in home, school, workplace, community and other settings. Occupational therapy services are provided for the purpose of promoting health and wellness and are provided to those who have or are at risk for developing an illness, injury, disease, disorder, condition, impairment, disability, activity limitation, or participation restriction. Occupational therapists address the physical, cognitive, psychosocial, sensory, and other aspects of occupational performance in a variety of contexts to support engagement in everyday life activities that affect health, well-being, and quality of life. |
| Notes: Source: The Guide to Occupational Therapy Practice, 2nd edition. Bethesda: American Occupational Therapy Association, 2007. [7/1/2008: definition changed, added source] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629678289 | Life Wheels On PC | Occupational Therapist | 2248 Vintage Dr, Colorado Springs, CO 80920-3808 | 2020-10-31 |
| 1891395455 | Life Wheels On PC | Occupational Therapist | 13450 Smith Rd Ste 600, Aurora, CO 80011-2042 | 2020-10-31 |
| 1881294502 | Beyond Milestones Occupational Therapy, LLC | Occupational Therapist | 1021 Canal Dr, Windsor, CO 80550 | 2020-10-30 |
| 1700485059 | Joyce Ho | Occupational Therapist | 2586 Trailridge Dr E Ste 100, Lafayette, CO 80026-3111 | 2020-10-19 |
| 1932707833 | Caitlin Rose Martin | Occupational Therapist | 710 City Park Ave Apt B230, Fort Collins, CO 80521-3448 | 2020-10-13 |
| 1992302962 | Sarah S Beetch | Occupational Therapist | 201 Alder Hall 850 S Mason St, Fort Collins, CO 80523-0001 | 2020-10-02 |
| 1447867502 | Jodi Erin Henderson | Occupational Therapist | 86 Weant Blvd, Carbondale, CO 81623-2040 | 2020-09-23 |
| 1457967853 | Lindsey A. Cameron-aparicio | Occupational Therapist | 53 3rd St, Penrose, CO 81240-9105 | 2020-09-21 |
| 1871107904 | Samantha Kaisha Mcneely | Occupational Therapist | 714 W Orman Ave, Pueblo, CO 81004-1428 | 2020-09-05 |
| 1457965584 | Dragonfly Pediatric Speech Therapy | Occupational Therapist | 16315 Bluebell Pl, Parker, CO 80134-9248 | 2020-09-05 |
| Find all providers with the same taxonomy | ||||
| City | CANNON CITY |
| Zip Code | 81212 |
Please comment or provide details below to improve the information on BUCK JACK LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.