Buck Jack LLC
NPI 1467050658 · Occupational Therapist · Fountain, CO
Provider details
- NPI number
- 1467050658
- Entity type
- Organization
- Primary specialty
- Occupational TherapistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
- Organization subpart
- No
- Authorized official
- Rebecca Newman, Billing Manager(719) 597-0822
Specialties & taxonomies
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
- Behavior Analyst103K00000X
Behavioral Health & Social Service Providers
- Psychologist103T00000X
Behavioral Health & Social Service Providers
- Physical Therapist225100000X
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
- Speech-Language Pathologist235Z00000X
Speech, Language and Hearing Service Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
5 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Other names (DBA / former)
- Doing business as
- The Shandy Clinic
Registry dates
- Enumerated
- 2020-10-12
- Last updated
- 2020-10-12
- Certified
- 2020-10-06
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.