BUCK JACK LLC
NPI 1376141572
Occupational Therapist in Pueblo, CO

Active since October 12, 2020
1321 S PRAIRIE AVE, PUEBLO, CO 81005(719) 597-0822(719) 599-4606 Get Directions Write a Review

NPPES record last updated: October 12, 2020. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Buck Jack Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BUCK JACK LLC (NPI 1376141572), doing business as The Shandy Clinic, is a healthcare organization registered as an occupational therapist in Pueblo, Colorado and active in the NPI registry since October 2020. The organization lists Rebecca Newman, Billing Manager, as its authorized official.

NPPES Registry Identity

NPI1376141572
Entity TypeOrganization
Primary Taxonomy225X00000X
Legal Business NameBUCK JACK LLC
Location Address1321 S PRAIRIE AVEPueblo, CO 81005-2307
Mailing Address685 Citadel Dr E Ste 580Colorado Springs, CO 80909-5381 · (719) 597-0822 · Fax (719) 599-4606
Fax(719) 599-4606
Organization SubpartNo
Authorized OfficialRebecca NewmanBilling Manager · (719) 597-0822
Enumeration DateOctober 12, 2020
NPPES CertifiedOctober 6, 2020
NPI 1376141572 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 5

Primary SpecialtyOccupational TherapistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Taxonomy Code225X00000X
Definition

An occupational therapist is a person who has graduated from an entry-level occupational therapy program accredited by the Accreditation Council for Occupational Therapy Education (ACOTE) or predecessor organizations, or approved by the World Federation of Occupational Therapists (WFOT), or an equivalent international occupational therapy education program; has successfully completed a period of supervised fieldwork experience required by the occupational therapy program; has passed a nationally recognized entry-level examination for occupational therapists, and fulfills state requirements for licensure, certification, or registration. An occupational therapist provides interventions based on evaluation and which emphasize the therapeutic use of everyday life activities (i.e., occupations) with individuals or groups for the purpose of facilitating participation in roles and situations and in home, school, workplace, community and other settings. Occupational therapy services are provided for the purpose of promoting health and wellness and are provided to those who have or are at risk for developing an illness, injury, disease, disorder, condition, impairment, disability, activity limitation, or participation restriction. Occupational therapists address the physical, cognitive, psychosocial, sensory, and other aspects of occupational performance in a variety of contexts to support engagement in everyday life activities that affect health, well-being, and quality of life.

Also ListedBehavior AnalystTaxonomy 103K00000X
Also ListedPsychologistTaxonomy 103T00000X
Also ListedPhysical TherapistTaxonomy 225100000X
Also ListedSpeech-Language PathologistTaxonomy 235Z00000X
1321 S PRAIRIE AVE, Pueblo, CO 81005

Other Names 1

Doing Business AsThe Shandy Clinic

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Physical Therapist
1321 S PRAIRIE AVE
PUEBLO, CO 81005
Speech-Language Pathologist
1321 S PRAIRIE AVE
PUEBLO, CO 81005
Speech-Language Pathologist
1321 S PRAIRIE AVE
PUEBLO, CO 81005
Speech-Language Pathologist
1321 S PRAIRIE AVE
PUEBLO, CO 81005
Physical Therapist
1321 S PRAIRIE AVE
PUEBLO, CO 81005
Occupational Therapist
1321 S PRAIRIE AVE
PUEBLO, CO 81005
Physical Therapist
1321 S PRAIRIE AVE
PUEBLO, CO 81005
Behavior Technician
1321 S PRAIRIE AVE
PUEBLO, CO 81005

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Buck Jack LLC's NPI number?

The NPI number for Buck Jack LLC is 1376141572. It was assigned to this organization in the NPPES registry on October 12, 2020.

Where is Buck Jack LLC located?

Buck Jack LLC is located at 1321 S Prairie Ave, Pueblo, CO 81005. The listed phone number is (719) 597-0822.

What is Buck Jack LLC's specialty?

The primary specialty registered for this NPI is Occupational Therapist with taxonomy code 225X00000X.

When was this NPI record last updated?

The NPPES record for Buck Jack LLC was last updated on October 12, 2020. NPI Profile syncs with the weekly NPPES data releases published by CMS.