Individual provider Active NPI

Shaun Kenneth Geoffrey Colburn, M.D.

  • Clinical Cardiac Electrophysiology Physician
  • Kingsport, TN
National Provider Identifier
1235511932
Registry record updated Mar 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Cardiac Electrophysiology PhysicianTaxonomy code 207RC0001X
License
66832 Issued in TN
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

Updated by the provider on Mar 5, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230504001558 TN Practitioner - Internal Medicine 8729394051 Reassigns benefits to 1 organization

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
Wellmont Cardiology ServicesGroup PAC ID 5799970281, 137 clinicians

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

ProcedureNumber of procedures
Pacemaker insertion or repair36

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
66832TNMDFamily Medicine Physician
MT209561PAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wellmont Cardiology Services Cardiovascular Disease CurrentSince Jul 1, 2023 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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

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

Verify at the official NPI Registry.