Individual provider Active NPI

Tara Renee Sutherland

  • Behavior Analyst
  • Colorado Springs, CO
National Provider Identifier
1164043212
Registry record updated Jan 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-25-81491 Issued in CO
Practice address
445 E Cheyenne MTN Blvd.
Ste C-372
Colorado Springs, CO 80906-4570
Phone
(855) 832-6727
Fax
(772) 675-9100
NPI assigned
Apr 29, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X 1-25-81491 CO Primary
Behavior Technician 106S00000X RBT-20-116552 CO

Addresses

Primary practice location

445 E Cheyenne MTN Blvd.
Ste C-372
Colorado Springs, CO 80906-4570

Mailing address

1915 Aerotech Dr Ste 180
Colorado Springs, CO 80916-4213
Phone (719) 301-5100

Other identifiers 1

IdentifierTypeStateIssuer
1790211605MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
RBT-20-116552COMDBehavior Technician

NPI Registry JSON

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

{
    "created_epoch": "1588118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769299200000",
    "number": "1164043212",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1915 AEROTECH DR STE 180",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809164213",
            "telephone_number": "719-301-5100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "445 E CHEYENNE MTN BLVD.",
            "address_2": "STE C-372",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809064570",
            "telephone_number": "855-832-6727",
            "fax_number": "772-675-9100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUTHERLAND",
        "first_name": "TARA",
        "middle_name": "RENEE",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-29",
        "last_updated": "2026-01-25",
        "certification_date": "2026-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "CO",
            "license": "1-25-81491",
            "primary": true
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "CO",
            "license": "RBT-20-116552",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1790211605",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 Jan 25, 2026; 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.