Mary Colburn, APRN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

007605 Issued in CT

Practice address

850 N Main Street Ext
Wallingford, CT 06492-2400

Phone

(203) 626-4203

Fax

(203) 626-1624

NPI assigned

Jun 12, 2018

Last updated

Dec 16, 2025By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CT

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2018

Medicare assignment

May accept Medicare assignment

Telehealth

Offers telehealth services

Group practices

TPTC-NH LLCGroup PAC ID 8921479502, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mary.colburn.p1@direct.wheelerclinic.nextgenshare.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Alleviate Pain and Wellness

  • Family Nurse Practitioner
  • Wallingford, CT
  • NPI 1073407037
  Medicare reassignment NPD Authorized official
• TPTC-NH, LLC

  dba Total Pain Treatment Centers of CT

  • Family Nurse Practitioner
  • New Haven, CT
  • NPI 1265144935
  Medicare reassignment Care Compare group NPD
• Wheeler Clinic Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Plainville, CT
  • NPI 1396750840
  Medicare reassignment NPD
• Matrix Medical Plus

  • Nurse Practitioner
  • Nashville, TN
  • NPI 1376973461

  CT

  Medicare reassignment NPD
• Wheeler Clinic Inc

  • Federally Qualified Health Center (FQHC)
  • Bristol, CT
  • NPI 1790532802
  NPD

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

{
    "created_epoch": "1528761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765843200000",
    "number": "1679066948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "850 N MAIN STREET EXT",
            "city": "WALLINGFORD",
            "state": "CT",
            "postal_code": "064922400",
            "telephone_number": "203-626-4203",
            "fax_number": "203-626-1624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "850 N MAIN STREET EXT",
            "city": "WALLINGFORD",
            "state": "CT",
            "postal_code": "064922400",
            "telephone_number": "203-626-4203",
            "fax_number": "203-626-1624"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLBURN",
        "first_name": "MARY",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-06-12",
        "last_updated": "2025-12-16",
        "certification_date": "2025-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CT",
            "license": "007605",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Club Staffing
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• Miriam Susan Cohen, M.D.
• Elena Colaci, OTR/L
• Erica P Colavolpe, APRN
• Michael Collins, M.D.
• Colony Opticians
• James J Comeau, L.O.
• Brendan John Comer, MD
• Communicate With Me, Speech Therapy LLC

• Family Nurse Practitioner in Wallingford, CT
• Providers in Wallingford, CT by specialty
• Family Nurse Practitioner in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 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.

Verify at the official NPI Registry.