BUCK JACK LLC (NPI# 1871106997) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871106997 |
| Entity Type | Organization |
| Organization Name | BUCK JACK LLC |
| Other Organization Name | THE SHANDY CLINIC |
| Practice Address |
830 Tenderfoot Hill Rd Ste 100 Colorado Springs CO 80906-7372 |
| Mailing Address |
685 Citadel Dr E Ste 580 Colorado Springs CO 80909-5381 |
| Practice Telephone | 7196234500 |
| Mailing Telephone | 7137259181 |
| Enumeration Date | 2020-08-28 |
| Last Update Date | 2020-10-01 |
| Authorized Official Name | WILLIAM COLT (PRESIDENT) |
| Authorized Official Telephone | 7134106889 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 103K00000X | Behavioral Analyst | Behavioral Health & Social Service Providers | ||
| N | 103T00000X | Psychologist | Behavioral Health & Social Service Providers | ||
| N | 103TC0700X |
Psychologist Specialization: Clinical |
Behavioral Health & Social Service Providers | ||
| 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 |
830 TENDERFOOT HILL RD STE 100 |
| City | COLORADO SPRINGS |
| State | CO |
| Zip Code | 80906-7372 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912269267 | Jessica Lyn Nicole Stephens | Specialist/Technologist | 830 Tenderfoot Hill Rd Ste 100, Colorado Springs, CO 80906-7372 | 2012-06-12 |
| 1568060754 | Buck Jack LLC | Behavioral Analyst | 830 Tenderfoot Hill Rd Ste 100, Colorado Springs, CO 80906-7372 | 2020-10-12 |
| 1700483377 | Amy Shandy, Speech-language Pathologist, LLC | Behavioral Analyst | 830 Tenderfoot Hill Rd Ste 100, Colorado Springs, CO 80906-7372 | 2020-10-06 |
| 1649885989 | Amy Shandy, Speech-language Pathologist, LLC | Behavioral Analyst | 830 Tenderfoot Hill Rd Ste 100, Colorado Springs, CO 80906-7372 | 2020-09-14 |
| 1699321844 | Abby Elaine Paschal | Physical Therapist | 830 Tenderfoot Hill Rd Ste 100, Colorado Springs, CO 80906-7372 | 2019-08-14 |
| 1053967158 | Dru Renee Harwood | Occupational Therapist | 830 Tenderfoot Hill Rd Ste 100, Colorado Springs, CO 80906-7372 | 2019-08-14 |
| 1649822172 | Karen Rosini | Speech-Language Pathologist | 830 Tenderfoot Hill Rd Ste 100, Colorado Springs, CO 80906-7372 | 2019-07-15 |
| 1740746148 | Jamie Alexander Budhan | Speech-Language Pathologist | 830 Tenderfoot Hill Rd Ste 100, Colorado Springs, CO 80906-7372 | 2019-02-11 |
| 1871058107 | Morgan Bowser | Speech-Language Pathologist | 830 Tenderfoot Hill Rd Ste 100, Colorado Springs, CO 80906-7372 | 2019-01-31 |
| 1912493123 | Katie Alyssa Hanson | Occupational Therapist | 830 Tenderfoot Hill Rd Ste 100, Colorado Springs, CO 80906-7372 | 2018-07-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437797339 | Michael Crise | Behavior Technician | 1330 Qual Lake Loop Ste 120, Colorado Springs, CO 80906 | 2019-12-11 |
| 1730720541 | Amanda Salinas | Massage Therapist | 1235 Lake Plaza Drive Suite 230, Colorado Springs, CO 80906 | 2019-10-02 |
| 1225511488 | Sheila Meggison | Massage Therapist | 1235 Lake Plaza Drive, Suite 230, Colorado Springs, CA 80906 | 2018-09-12 |
| 1316429756 | Vivus Counseling Services LLC | Counselor | 108 East Cheyenne Rd Suite 201, Colorado Springs, CO 80906 | 2018-09-01 |
| 1043796949 | Erin Lee Recinos | Nurse Practitioner | 225 E Cheyenne Mountain Blvd Ste 220, Colorado Springs, CO 80906 | 2018-07-13 |
| 1982103875 | Savannah Adeline Rentrop | Behavior Technician | 2989 Broadmoor Valley Rd D, Colorado Springs, CO 80906 | 2018-02-06 |
| 1205335288 | Ross Knowlton | Behavior Technician | 1330 Quail Lake Loop Suite 200, Colorado Springs, CO 80906 | 2018-02-06 |
| 1942709845 | Adrienne Bohlen | Behavior Technician | 1330 Quail Lake Loop, Ste. 200, Colorado Springs, CO 80906 | 2018-02-06 |
| 1881110088 | Christine Gonzales | Nurse Practitioner | 2739 E Las Vegas St, Colorado Springs, CO 80906 | 2017-08-18 |
| 1225568470 | Larry Alwine | Counselor | 2860 South Circle Drive, Unit 250k, Colorado Springs, CO 80906 | 2017-06-19 |
| Find all providers in zip 80906 | ||||
| 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 |
|---|---|---|---|---|
| 1093312639 | Mary Cogswell | Speech-Language Pathologist | 3024 Ellesmere Dr, Colorado Springs, CO 80922-1275 | 2020-10-06 |
| 1770195562 | Chloe Canaan | Speech-Language Pathologist | 11136 Cypress Tree Pt Apt 306, Colorado Springs, CO 80921-7709 | 2020-08-21 |
| 1598377582 | Leah Schrimpf | Speech-Language Pathologist | 1060 Harrison Rd, Colorado Springs, CO 80905-3586 | 2020-08-20 |
| 1912517269 | Sarah Wrede | Speech-Language Pathologist | 1525 Witches Willow Ln, Colorado Springs, CO 80906-6208 | 2020-08-02 |
| 1609485556 | Jane Allison Morgan | Speech-Language Pathologist | 18465 Woodhaven Dr, Colorado Springs, CO 80908-1303 | 2020-07-27 |
| 1194334169 | Jill Tullman & Associates, LLC | Speech-Language Pathologist | 7222 Commerce Center Dr Ste 255, Colorado Springs, CO 80919-2632 | 2020-07-27 |
| 1467070250 | Savannah Love Lee | Speech-Language Pathologist | 419 E Saint Vrain St, Colorado Springs, CO 80903-3020 | 2020-07-08 |
| 1205464880 | Madison Kurtz | Speech-Language Pathologist | 2233 Academy Pl Ste 200, Colorado Springs, CO 80909-1666 | 2020-03-30 |
| 1629604848 | Shyanne Heise | Speech-Language Pathologist | 1710 Jet Stream Dr Ste 105, Colorado Springs, CO 80921-3937 | 2020-03-19 |
| 1861025488 | Katie Monson | Speech-Language Pathologist | 4136 Coolwater Dr, Colorado Springs, CO 80916-5522 | 2020-02-21 |
| Find all providers in COLORADO SPRINGS | ||||
| City | COLORADO SPRINGS |
| Zip Code | 80906 |
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.