NPIMap

Organization Active NPI

Buck Jack LLC

Doing business as Woven Care

  • Speech-Language Pathologist
  • Denver, CO
National Provider Identifier
1093312258
Registry record updated Feb 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Legal business name
BUCK JACK LLC
Doing business as
Woven Care
Practice address
3901 E Yale Ave
Denver, CO 80210-6646
Phone
(719) 597-0822
Fax
(719) 599-4606
NPI assigned
Oct 1, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 29, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Tanner DennNPI 1336866565
Title
Credentialing Specialist
Phone
(719) 428-1840

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X
Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225X00000X
Speech-Language PathologistGroup: 193200000X MULTI-SPECIALTY GROUP 235Z00000X Primary

Addresses

Primary practice location

3901 E Yale Ave
Denver, CO 80210-6646

Mailing address

2233 Academy PL Ste 200
Colorado Springs, CO 80909-1666
Phone (719) 597-0822

Other names 1

  • Woven Care Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Buck Jack LLC70 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 19

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 19

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1601510400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709164800000",
    "number": "1093312258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2233 ACADEMY PL STE 200",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809091666",
            "telephone_number": "719-597-0822",
            "fax_number": "719-599-4606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3901 E YALE AVE",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802106646",
            "telephone_number": "719-597-0822",
            "fax_number": "719-599-4606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BUCK JACK LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-01",
        "last_updated": "2024-02-29",
        "certification_date": "2024-02-29",
        "status": "A",
        "authorized_official_last_name": "DENN",
        "authorized_official_first_name": "TANNER",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "719-428-1840"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Woven Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Denver, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 29, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.