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Buck Jack, LLC

Behavior Analyst in Pueblo, CO · enumerated 2024 · authorized official Tanner Hall, Credentialing Specialist.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1700694908

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Registry record

Entity type Organization (Type 2)
Legal business name Buck Jack, LLC
Practice address 1321 S Prairie Ave, Pueblo, CO, 81005
Phone (719) 597-0822
Fax (719) 599-4606
Enumeration date Dec 20, 2024
Last updated in NPPES Dec 20, 2024

Taxonomy & classification

103K00000X Behavior Analyst Behavioral Health & Social Service Providers Primary
106S00000X Behavior Technician Behavioral Health & Social Service Providers Secondary
224Z00000X Occupational Therapy Assistant Respiratory, Developmental, Rehabilitative and Restorative Service Providers Secondary
225100000X Physical Therapist Respiratory, Developmental, Rehabilitative and Restorative Service Providers Secondary
225200000X Physical Therapy Assistant Respiratory, Developmental, Rehabilitative and Restorative Service Providers Secondary
225X00000X Occupational Therapist Respiratory, Developmental, Rehabilitative and Restorative Service Providers Secondary
2355S0801X Speech-Language Assistant Speech, Language and Hearing Service Providers Secondary
235Z00000X Speech-Language Pathologist Speech, Language and Hearing Service Providers Secondary

Authorized official

Name Tanner Hall
Title Credentialing Specialist
Phone (719) 597-0822

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.

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Frequently asked questions

Where is Buck Jack, LLC located?
The practice location on file with NPPES is in Pueblo, CO.
How current is this record?
Data comes from the CMS NPPES public dissemination file; this record was last updated in NPPES on 2024-12-20. Verify at npiregistry.cms.hhs.gov.

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2024-12-20.