Buck Jack, LLC
Buck Jack, LLC is a healthcare organization registered as Occupational Therapist in Pueblo, CO, holding Type 2 (organization) NPI 1073491429 since 2025. The authorized official on file is Tanner Hall, Internal Operations Manager.
✓ Active NPI ✓ Valid NPI checksum
| NPI | 1073491429 |
|---|---|
| Entity type | Organization (Type 2) |
| Legal business name | Buck Jack, LLC |
| Practice address | 4025 CLUB MANOR DR, Pueblo, CO, 81008 |
| Phone | 7195970822 |
| Enumeration date | 2025-08-25 |
| Last updated in NPPES | 2025-08-25 |
Authorized official
| Name | Tanner Hall |
|---|---|
| Title | Internal Operations Manager |
| Phone | 7195970822 |
Taxonomy & classification
| Taxonomy code | Specialty | Primary | License | State |
|---|---|---|---|---|
| 103K00000X | Behavior Analyst | Secondary | — | — |
| 106S00000X | Behavior Technician | Secondary | — | — |
| 224Z00000X | Occupational Therapy Assistant | Secondary | — | — |
| 225100000X | Physical Therapist | Secondary | — | — |
| 225200000X | Physical Therapy Assistant | Secondary | — | — |
| 235Z00000X | Speech-Language Pathologist | Secondary | — | — |
| 225X00000X | Occupational Therapist | Primary | — | — |
Copy-ready billing details
Provider: Buck Jack, LLC NPI: 1073491429 Taxonomy: 225X00000X (Occupational Therapist) Address: 4025 CLUB MANOR DR, Pueblo, CO, 81008
Providers at this address
| NPI | Name | Type | Specialty | Location |
|---|---|---|---|---|
| 1316058126 | Catholic Health Initiatives Colorado | Organization | Home Health Agency | Pueblo, CO |
| 1982582334 | Buck Jack, LLC | Organization | Behavior Analyst | Pueblo, CO |
| 1356215859 | Liliana Aragon | Individual | Behavior Technician | Pueblo, CO |
| 1174497671 | Jerrica Fletcher | Individual | Behavior Technician | Pueblo, CO |
| 1851241293 | Kenzie Stapleton | Individual | Behavior Technician | Pueblo, CO |
| 1033069489 | Alaina Eckhardt | Individual | Behavior Technician | Pueblo, CO |
| 1942151444 | Marissa Montano | Individual | Behavior Technician | Pueblo, CO |
| 1518811249 | Morgan Parker | Individual | Behavior Technician | Pueblo, CO |
Verify this record
Cross-check NPI 1073491429 against the authoritative CMS record: view Buck Jack, LLC on the official NPPES registry .
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes — even if the provider moves or changes specialty. Read the full guide or validate an NPI number.
Frequently asked questions
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Source: CMS NPPES (public data). Snapshot 2026-07-11. Provider record last updated 2025-08-25.