BUCK JACK LLC (NPI# 1093312258) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093312258 |
| Entity Type | Organization |
| Organization Name | BUCK JACK LLC |
| Practice Address |
3901 E Yale Ave Denver CO 80210-6646 |
| 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 | 2020-10-01 |
| Last Update Date | 2020-10-01 |
| 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 | 225X00000X | Occupational Therapist | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | ||
| Y | 235Z00000X | Speech-Language Pathologist | Speech, Language and Hearing Service Providers |
| Other Name | Type Code |
|---|---|
| THE SHANDY CLINIC | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083212393 | Buck Jack LLC | Physical Therapist | Mountain View Core Knowledge School 890 Field Ave, Cannon City, CO 81212 | 2020-10-09 |
| 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 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Colorado Business Entities | Buck Jack LLC | 419 South Tejon Appt. 309, Colorado Springs, CO 80903 |
| Street Address |
3901 E YALE AVE |
| City | DENVER |
| State | CO |
| Zip Code | 80210-6646 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770032641 | The Young Men's Christian Association of Metropolitan Denver | Health Educator | 3901 E Yale Ave, Denver, CO 80210 | 2016-10-03 |
| 1255932919 | Sarai Williams | Health Educator | 3901 E Yale Ave, Denver, CO 80210-6646 | 2020-11-07 |
| 1619575909 | Buck Jack LLC | Physical Therapist | 3901 E Yale Ave, Denver, CO 80210-6646 | 2020-10-09 |
| 1669008660 | Amy B Ventura | Health Educator | 3901 E Yale Ave, Denver, CO 80210-6646 | 2020-03-21 |
| 1396370102 | Amy Shandy, Speech-language Pathologist, LLC | Physical Therapist | 3901 E Yale Ave, Denver, CO 80210-6646 | 2020-03-12 |
| 1720554637 | Kim I Alladice | Health Educator | 3901 E Yale Ave, Denver, CO 80210-6646 | 2018-10-17 |
| 1306348206 | Jessica Giffin | Health Educator | 3901 E Yale Ave, Denver, CO 80210-6646 | 2018-03-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508408360 | Carley Danielle Westerson | Counselor | 290 North Williams Street, Room #205, Denver, CO 80210 | 2019-10-14 |
| 1427690429 | Katherine Elizabeth Mullen | Chiropractor | 1313 S Clarkson St. Unit 1, Denver, CO 80210 | 2019-10-10 |
| 1922665975 | Amy Welsh, Inc | Occupational Therapist | 1588 S Logan St, Denver, CO 80210 | 2019-05-24 |
| 1598328346 | Heather Lynn Stone | Social Worker | 950 E Porter Avenue #670, Denver, CO 80210 | 2019-04-17 |
| 1669952909 | Christopher G. Sharrow | Social Worker | 1777 S. Harrison St., Suite 1200, Denver, CO 80210 | 2018-08-16 |
| 1922598952 | Rebecca Turlo | Hearing Instrument Specialist | 950 E Harvard Ave Ste E620, Denver, CO 80210 | 2018-05-15 |
| 1215446083 | Alex James Koch | Acupuncturist | 1110 E Evans Ave, Denver, CO 80210 | 2017-09-25 |
| 1043738495 | Sarah Urycki | Counselor | 2317 A S Race Street, Denver, CO 80210 | 2017-09-06 |
| 1831647437 | Samantha Johnson | Nurse Practitioner | 450 E Harvard Ave, Denver, CO 80210 | 2016-09-13 |
| 1629446117 | Scott King | Chiropractor | 900 E Louisiana Ave, #201, Denver, CO 80210 | 2015-09-14 |
| Find all providers in zip 80210 | ||||
| Taxonomy Code | 235Z00000X |
| Grouping | Speech, Language and Hearing Service Providers |
| Classification | Speech-Language Pathologist |
| The speech-language pathologist is the professional who engages in clinical services, prevention, advocacy, education, administration, and research in the areas of communication and swallowing across the life span from infancy through geriatrics. Speech-language pathologists address typical and atypical impairments and disorders related to communication and swallowing in the areas of speech sound production, resonance, voice, fluency, language (comprehension and expression), cognition, and feeding and swallowing. |
| Notes: "Scope of Practice in Speech-Language Pathology", American Speech-Language-Hearing Association, 2013. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457958423 | Amy Maule | Speech-Language Pathologist | 4208 Lipan St, Denver, CO 80211-2547 | 2020-10-02 |
| 1619582939 | Michelle Bernstein | Speech-Language Pathologist | 1200 N Grant St Apt 312, Denver, CO 80203-2773 | 2020-09-14 |
| 1639784911 | Claire R Opel | Speech-Language Pathologist | 1699 S Trenton St Unit 3, Denver, CO 80231-5601 | 2020-09-13 |
| 1427660570 | Live The Dream Speech and Language LLC | Speech-Language Pathologist | 1801 Bassett St Apt 1-409, Denver, CO 80202-1011 | 2020-08-20 |
| 1528676566 | Megan Errera | Speech-Language Pathologist | 2442 W 33rd Ave, Denver, CO 80211-3328 | 2020-07-15 |
| 1184248205 | Lisa Niffenegger, LLC | Speech-Language Pathologist | 6200 E Cornell Ave, Denver, CO 80222-7013 | 2020-06-04 |
| 1043831043 | Kerri Potthoff | Speech-Language Pathologist | 2085 Bryant St, Denver, CO 80211-5114 | 2020-04-30 |
| 1386264786 | Madeleine Julia Wegmann | Speech-Language Pathologist | 875 S Josephine St, Denver, CO 80209-4714 | 2020-04-26 |
| 1225676349 | Ashlee Rae Musgrave | Speech-Language Pathologist | 1225 S Columbine St, Denver, CO 80210-1916 | 2019-12-19 |
| 1114565488 | Monique Clare Wehrle | Speech-Language Pathologist | 349 S Kearney St, Denver, CO 80224-1235 | 2019-12-17 |
| Find all providers in DENVER | ||||
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| 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.