Buck Jack LLC
NPI 1083212393ActiveOrganization· Occupational Therapist· Cannon City, CO
Occupational Therapist in Cannon City, Colorado, registered in NPPES in October 2020. The authorized official on file is Tanner Denn, Credentialing Specialist.
Overview
| NPI | 1083212393 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Oct 9, 2020 |
| Last updated in NPPES | Feb 28, 2024 |
| Certified by provider | Feb 28, 2024 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Occupational Therapist Primary | 225X00000X | — | — |
| 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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