Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Tarah Tracy Thevenot

Individual provider Family Medicine Physician · NPI 1275146524

Tarah Tracy Thevenot is a Family Medicine Physician in Colorado Springs, Colorado. Practices as a sole proprietor and works from 2 locations. Licensed in Colorado and Florida.

Licensed in
CO, FL
In the registry since
2020
Specialties on file
3
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Practice location Address checks out

1702 E Pikes Peak Ave
Colorado Springs, CO 80909-5717
Phone: (719) 358-7338
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 4238 Ne 29th Pl, Ocala, FL 34470-3366 — (352) 233-8577

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X · Licence C-APN.0002436-C-NP (CO)
Family Medicine Physician Taxonomy 207Q00000X · Licence 11008733 (FL)
Family Nurse Practitioner Taxonomy 363LF0000X · Licence 11008733 (FL)

Record details

NPI number1275146524
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedAugust 26, 2020
Last updated in NPPESNovember 5, 2021
Certification dateNovember 5, 2021

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