Jeffrey S. Colburn, MD
Individual provider Active NPI Family Medicine Physician · Chattanooga, TN
NPI 1780979211 · NPPES record last updated Oct 18, 2024
Key facts
- NPI
- 1780979211
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 0101270308 (VA)
- Practice address
- 2030 Hamilton Place Blvd Ste 220
Chattanooga, TN 37421-6040 - Phone
- (423) 892-4289
- NPI assigned
- Jun 13, 2011
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 6
Hospital & facility affiliations 4
Owned or controlled facilities with NPI records 1
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- Other, 2011
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Legacy Care Aco LLC
Legacy Care LLC
Practice addresses (Care Compare)
2420 Pemberton Rd
Richmond, VA 23233-2003
Phone (804) 747-9200
2901 S Lynnhaven Rd
Suite 450
Virginia Beach, VA 23452-8524
780 Lynnhaven Pkwy
Suite 400
Virginia Beach, VA 23452-7332
Phone (757) 536-2246
Hospital & facility affiliations
- Bayada Home Health Care - Yorktown
- Legacy Hospice
- Windsor Grove Health and Rehabilitation
- Williamsburg Post Acute & Rehabilitation
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (4 enrollments) in AL, TN, GA, VA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
All facility ownership & control disclosures 1
| Facility | Type | Role | Since |
|---|---|---|---|
| Windsor Grove Health and Rehabilitation |
Skilled nursing facility | Operational/Managerial Control Adp of the SNF |
May 1, 2025 May 1, 2025 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20130109000688 | AL | Practitioner - Family Practice | 8022261692 | Reassigns benefits to 1 organization |
| I20140415001169 | TN | Practitioner - Family Practice | 8022261692 | |
| I20140922002462 | GA | Practitioner - Family Practice | 8022261692 | Reassigns benefits to 1 organization |
| I20230523003477 | VA | Practitioner - Family Practice | 8022261692 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 32025 | AL | MD | Family Medicine Physician |
| 0101270308 | VA | MD | Family Medicine Physician |
| 071481 | GA | MD | Hospitalist Physician |
| 50198 | TN | MD | Hospitalist Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Legacy Care LLC | Family Medicine | Current |
Accepting new patients |
| Legacy Care Aco LLC | Family Medicine | Current |
Accepting new patients |
| Signify Health, LLC | Current |
Accepting new patients | |
| Hamilton Physician Group Inc | Current |
Accepting new patients | |
| Medcenter Demopolis, LLC | Family Medicine | Current |
Accepting new patients |
| Hamilton Medical Center, Inc. | Current |
Accepting new patients |
Locations
705 US Highway 80 W
Demopolis, AL 36732
Phone (205) 333-1993
3909 McFarland Blvd
Northport, AL 35476
Phone (205) 330-1707
5005 Oscar Baxter Dr
Tuscaloosa, AL 35405
Phone (205) 333-4654
1200 Memorial Dr
Dalton, GA 30720
Phone (706) 272-6115
975 E 3rd St
Chattanooga, TN 37403
Phone (423) 266-1499
4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037
7600 Autumn Park Way
Mechanicsvlle, VA 23116
Phone (804) 730-0009
1806 Summit Ave
Richmond, VA 23230
Phone (213) 433-2823
2420 Pemberton Rd
Richmond, VA 23233
Phone (804) 254-5100
780 Lynnhaven Pkwy
Ste 400
Virginia Beach, VA 23452
Phone (201) 581-3411
2901 S Lynnhaven Rd
Ste 450
Virginia Beach, VA 23452
Phone (757) 351-4585
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 32025 | AL | |
| Family Medicine Physician | 207Q00000X | 50198 | TN | |
| Hospitalist Physician | 208M00000X | 071481 | GA | |
| Hospitalist Physician | 208M00000X | 50198 | TN | |
| Family Medicine Physician | 207Q00000X | 0101270308 | VA | Yes |
Addresses
Primary practice location
2030 Hamilton Place Blvd Ste 220
Chattanooga, TN 37421-6040
Mailing address
202 Jennifer Dr
Yorktown, VA 23693-3138
Phone (205) 529-7126
Other providers in Chattanooga, TN
- Cori Cohen
- Jonathan S Cohen
- Samantha Cohen
- Dora B Coker
- Logan Bryant Colbaugh
- Alexandra Colclough
- Cole Vision Corporation
- Daniel Jay Cole
- Darwin Reid Cole
- Jennifer Flanagan Cole
All providers in Chattanooga, TN · Family Medicine Physician in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 18, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.