Active NPI
Shaun Kenneth Geoffrey Colburn, M.D.
- Clinical Cardiac Electrophysiology Physician
- Kingsport, TN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Cardiac Electrophysiology Physician
- License
- 66832
- Practice address
- 2050 Meadowview Pkwy
Kingsport, TN 37660-7475 - Phone
- (423) 230-5000
- NPI assigned
- Jun 18, 2015
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 66832 | TN | |
| Internal Medicine Physician | 207R00000X | MT209561 | PA | |
| Cardiovascular Disease Physician | 207RC0000X | 66832 | TN | |
| Clinical Cardiac Electrophysiology Physician | 207RC0001X | 66832 | TN | Primary |
Addresses
Primary practice location
2050 Meadowview Pkwy
Kingsport, TN 37660-7475
Mailing address
1021 W Oakland Ave Ste 310
Johnson City, TN 37604-2192
Phone (423) 952-2111
Other practice location 1
111 S Front St
Harrisburg, PA 17101-2010
Phone (717) 231-8506
Other practice location 2
378 Marketplace Blvd Ste 5
Johnson City, TN 37604-2361
Phone (423) 282-0751
Other practice location 3
1410 Tusculum Blvd Ste 1500
Greeneville, TN 37745-5810
Phone (423) 638-2270
Other practice location 4
271 Medical Park Blvd
Bristol, TN 37620-7455
Phone (423) 274-8600
Other practice location 5
2428 Knob Creek Rd Ste 201
Johnson City, TN 37604-2396
Phone (423) 282-5054
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Internal Medicine
- Education
- Other, 2015
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1410 Tusculum Blvd
Suite 1500
Greeneville, TN 37745-5810
Phone (423) 638-2270
2050 Meadowview Pkwy
Kingsport, TN 37660-7475
Phone (423) 230-5000
2428 Knob Creek Rd
Suite 201
Johnson City, TN 37604-2396
Phone (423) 282-5054
271 Medical Park Blvd
Bristol, TN 37620-7455
Phone (423) 274-8600
Hospital & facility affiliations
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Pacemaker insertion or repair | 36 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 66832 | TN | MD | Family Medicine Physician |
| MT209561 | PA | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wellmont Cardiology Services | Cardiovascular Disease | Current | Accepting new patients |
| Wellmont Medical Associates Inc | Past | Accepting new patients | |
| Solstas Lab Partners Group LLC | Past | Accepting new patients |
Locations
1410 Tusculum Blvd
Ste 1500
Greeneville, TN 37745
Phone (423) 638-2270
1021 W Oakland Ave
Ste 310
Johnson City, TN 37604
Phone (423) 302-6565
378 Marketplace Blvd
Ste 5
Johnson City, TN 37604
Phone (423) 282-0751
2428 Knob Creek Rd
Ste 201
Johnson City, TN 37604
Phone (423) 262-4400
2050 Meadowview Pkwy
Kingsport, TN 37660
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Cardiovascular Disease Physician
- Kingsport, TN
- NPI 1376575035
-
- Clinical Medical Laboratory
- Valdosta, GA
- NPI 1407850985
-
- Family Medicine Physician
- Big Stone Gap, VA
- NPI 1174808216
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Bristol, TN
- NPI 1124058615
-
- General Acute Care Hospital
- Kingsport, TN
- NPI 1487690400
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1434585600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1741132800000",
"number": "1235511932",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1021 W OAKLAND AVE STE 310",
"city": "JOHNSON CITY",
"state": "TN",
"postal_code": "376042192",
"telephone_number": "423-952-2111",
"fax_number": "423-282-1657"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2050 MEADOWVIEW PKWY",
"city": "KINGSPORT",
"state": "TN",
"postal_code": "376607475",
"telephone_number": "423-230-5000"
}
],
"practiceLocations": [
{
"address_1": "111 S Front St",
"address_purpose": "LOCATION",
"city": "Harrisburg",
"state": "PA",
"postal_code": "171012010",
"country_code": "US",
"telephone_number": "717-231-8506",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "378 Marketplace Blvd Ste 5",
"address_purpose": "LOCATION",
"city": "Johnson City",
"state": "TN",
"postal_code": "376042361",
"country_code": "US",
"telephone_number": "423-282-0751",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1410 Tusculum Blvd Ste 1500",
"address_purpose": "LOCATION",
"city": "Greeneville",
"state": "TN",
"postal_code": "377455810",
"country_code": "US",
"telephone_number": "423-638-2270",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "271 Medical Park Blvd",
"address_purpose": "LOCATION",
"city": "Bristol",
"state": "TN",
"postal_code": "376207455",
"country_code": "US",
"telephone_number": "423-274-8600",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "2428 Knob Creek Rd Ste 201",
"address_purpose": "LOCATION",
"city": "Johnson City",
"state": "TN",
"postal_code": "376042396",
"country_code": "US",
"telephone_number": "423-282-5054",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "COLBURN",
"first_name": "SHAUN",
"middle_name": "KENNETH GEOFFREY",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2015-06-18",
"last_updated": "2025-03-05",
"certification_date": "2025-03-05",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "TN",
"license": "66832",
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "PA",
"license": "MT209561",
"primary": false
},
{
"code": "207RC0000X",
"taxonomy_group": "",
"desc": "Internal Medicine, Cardiovascular Disease",
"state": "TN",
"license": "66832",
"primary": false
},
{
"code": "207RC0001X",
"taxonomy_group": "",
"desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
"state": "TN",
"license": "66832",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Kingsport, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.