Buck Jack LLC
NPI 1053919365ActiveOrganization· Occupational Therapist· Colorado Springs, CO
Occupational Therapist in Colorado Springs, Colorado, registered in NPPES in October 2020. The authorized official on file is Tanner Hall, Credentialing Specialist.
Overview
| NPI | 1053919365 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Oct 9, 2020 |
| Last updated in NPPES | Dec 19, 2024 |
| Certified by provider | Dec 19, 2024 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Occupational Therapist Primary | 225X00000X | — | — |
| Behavior Analyst | 103K00000X | — | — |
| Psychologist | 103T00000X | — | — |
| Physical Therapist | 225100000X | — | — |
| Speech-Language Pathologist | 235Z00000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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All 355 occupational therapists in Colorado Springs · All occupational therapists in Colorado