Active NPI
Buck Jack, LLC
Doing business as Woven Care
- Behavior Analyst
- Colorado Springs, CO
National Provider Identifier
1871301069
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- Legal business name
- BUCK JACK, LLC
- Doing business as
- Woven Care
- Practice address
- 3625 Citadel Dr S
Colorado Springs, CO 80909-5320 - Phone
- (719) 597-0822
- Fax
- (719) 599-4606
- NPI assigned
- Dec 20, 2024
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Tanner Hall
- Title
- Credentialing Specialist
- Phone
- (719) 597-0822
Specialties & licenses 8
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | Primary | ||
| Behavior Technician | 106S00000X | |||
| Occupational Therapy Assistant | 224Z00000X | |||
| Physical Therapist | 225100000X | |||
| Physical Therapy Assistant | 225200000X | |||
| Occupational Therapist | 225X00000X | |||
| Speech-Language Assistant | 2355S0801X | |||
| Speech-Language Pathologist | 235Z00000X |
Addresses
Primary practice location
3625 Citadel Dr S
Colorado Springs, CO 80909-5320
Mailing address
2233 Academy PL Ste 200
Colorado Springs, CO 80909-1666
Phone (719) 597-0822
Other names 1
- Woven Care
National Provider Directory
National Provider Directory- Tax ID family
- Buck Jack LLC
Organizations with this tax ID in the same state 24
This tax ID family is large, so up to 24 of its organizations in the same state are linked here.
Locations
3625 Citadel Dr S
Colorado Springs, CO 80909
Phone (719) 301-0002
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1734652800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1734652800000",
"number": "1871301069",
"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": "3625 CITADEL DR S",
"city": "COLORADO SPRINGS",
"state": "CO",
"postal_code": "809095320",
"telephone_number": "719-597-0822",
"fax_number": "719-599-4606"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "BUCK JACK, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2024-12-20",
"last_updated": "2024-12-20",
"certification_date": "2024-12-20",
"status": "A",
"authorized_official_last_name": "HALL",
"authorized_official_first_name": "TANNER",
"authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
"authorized_official_telephone_number": "719-597-0822"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Behavior Analyst",
"state": null,
"license": null,
"primary": true
},
{
"code": "106S00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Behavior Technician",
"state": null,
"license": null,
"primary": false
},
{
"code": "224Z00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Occupational Therapy Assistant",
"state": null,
"license": null,
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Physical Therapist",
"state": null,
"license": null,
"primary": false
},
{
"code": "225200000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Physical Therapy Assistant",
"state": null,
"license": null,
"primary": false
},
{
"code": "225X00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Occupational Therapist",
"state": null,
"license": null,
"primary": false
},
{
"code": "2355S0801X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Specialist/Technologist, Speech-Language Assistant",
"state": null,
"license": null,
"primary": false
},
{
"code": "235Z00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Speech-Language Pathologist",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Woven Care",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Colorado Springs, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 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.