Buck Jack, LLC
Buck Jack, LLC is a healthcare organization registered as Behavior Analyst in Pueblo, CO, holding Type 2 (organization) NPI 1205624111 since 2025. The authorized official on file is Tanner Hall, Internal Operations Manager.
✓ Active NPI ✓ Valid NPI checksum
| NPI | 1205624111 |
|---|---|
| Entity type | Organization (Type 2) |
| Legal business name | Buck Jack, LLC |
| Practice address | 304 E ROUTT AVE, Pueblo, CO, 81004 |
| Phone | 7195970822 |
| Fax | 7195994606 |
| Enumeration date | 2025-04-29 |
| Last updated in NPPES | 2025-04-29 |
Authorized official
| Name | Tanner Hall |
|---|---|
| Title | Internal Operations Manager |
| Phone | 7195970822 |
Taxonomy & classification
| Taxonomy code | Specialty | Primary | License | State |
|---|---|---|---|---|
| 106E00000X | Assistant Behavior Analyst | Secondary | — | — |
| 106S00000X | Behavior Technician | Secondary | — | — |
| 103K00000X | Behavior Analyst | Primary | — | — |
Copy-ready billing details
Provider: Buck Jack, LLC NPI: 1205624111 Taxonomy: 103K00000X (Behavior Analyst) Address: 304 E ROUTT AVE, Pueblo, CO, 81004
Providers at this address
| NPI | Name | Type | Specialty | Location |
|---|---|---|---|---|
| 1164084380 | Nathan Hughes | Individual | Behavior Analyst | Pueblo, CO |
| 1295523108 | Buck Jack, LLC | Organization | Occupational Therapist | Pueblo, CO |
| 1508748187 | Buck Jack, LLC | Organization | Speech-Language Pathologist | Pueblo, CO |
| 1659244374 | Mouk Pany | Individual | Behavior Technician | Pueblo, CO |
| 1588530158 | Taylah Vigil | Individual | Behavior Technician | Pueblo, CO |
| 1215805478 | Micaela Perez | Individual | Behavior Technician | Pueblo, CO |
| 1114887320 | Kayleigh Willis | Individual | Behavior Technician | Pueblo, CO |
| 1073477253 | Ciarra Mcdonald | Individual | Behavior Technician | Pueblo, CO |
Verify this record
Cross-check NPI 1205624111 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 2025-04-29.