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Deactivated NPI 1982344214 Deactivated / Inactive NPI Female Practitioner

Tiffany Colborn , NP

Nurse Practitioner • Herrin, IL

✓ Accepts Medicare Assignment
⚠️

Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Tiffany Colborn has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date April 01, 2022
NPI Deactivation Date April 01, 2022
Total Practice Duration ~1 Years of Practice (2022 – 2022)

Professional Overview & Biography Verified Profile Summary

Tiffany Colborn, NP was a registered Nurse Practitioner practicing in Herrin, IL. Throughout an active medical career spanning 1 years, Tiffany Colborn provided care at the practice location at 405 RUSHING DR until profile deactivation on 2022-04-01.

Tiffany Colborn maintained professional affiliations with Logan Primary Care Service Corp., Southern Illinois Medical Services Nfp and accepted Medicare assignment.

Historical Medicare Part B clinical services included urinalysis, manual test. Public procedure reimbursement records and service volume details are provided below for historical transparency.

Practice Location & Contact Primary Location

Practice Address

405 Rushing Dr

Herrin, IL 629483730

Telephone 6189933300
Fax 6189930262
Associated Practice Facility / Clinic

Medicare Profile & Education

Medical School

Other

Graduation Year

2022

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Nurse Practitioner in Herrin, IL

Rising Specialist (<5 Yrs)
Practitioner Clinical Experience
4 Yrs -4.1 yrs vs City Avg
City Avg: 8.1 Yrs
State Avg: 10.4 Yrs
Regional Practice Density
32 Specialists

Practicing in Herrin, IL (4929 Statewide)

Telehealth Adoption Rate
18.8% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
79.9% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Colborn (4 Years) 4 Yrs
Herrin Specialty Average (8.1 Years) 8.1 Yrs

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)
HCPCS Code & Description Services Patients Submitted Charge Medicare Allowed
81002 Urinalysis, manual test
25 22 $17.00 $3.41

Medical Specialties & State Licenses

CMS Verified: 2022-05-27
Nurse Practitioner Primary Specialty

NUCC Taxonomy Code: 363L00000X

State License IL 209025019

(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.

Hospital & Practice Group Affiliations

Southern Illinois Medical Services Nfp

405 Rushing Dr, Herrin, IL 629483730

Phone: 6189933300

Logan Primary Care Service Corp.

405 Rushing Dr, Herrin, IL 629483730

Secondary Practice Locations

502 W Saint Louis St Ste 4

West Frankfort, IL 628961968

Phone: 6189373400

2601 W Main St

Carbondale, IL 629011031

Phone: 6185495361

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

28 Associated Practitioners
Kristin Francis , LCSW

Social Worker - Clinical

NPI 1013362227

Licensed Clinical Social Worker

Dr. Gowda Sharath , MD

Internal Medicine

NPI 1043466576

Doctor of Medicine (M.D.)

Dr. Sarah Lahud Cuadra , MD

Internal Medicine - Geriatric Medicine

NPI 1053042739

Doctor of Medicine (M.D.)

Lenora Levin

Social Worker - Clinical

NPI 1093227613
Leslie Hickman , NP

Nurse Practitioner

NPI 1184196883

Nurse Practitioner

NPI 1184731267

Doctor of Medicine (M.D.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events
📍
Updated Practice Location May 05, 2022

Registered at 405 RUSHING DR, HERRIN, IL 629483730 (Tel: 6189933300)

📍
Updated Business Mailing Address May 05, 2022

Registered at PO BOX 3988, CARBONDALE, IL 629023988 (Tel: 6189933300)

👤
Provider Name / Credentials Updated May 05, 2022

Recorded as TIFFANY COLBORN, NP

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) May 05, 2022

Nurse Practitioner (License #209025019 in IL)

⚠️
NPI Profile Deactivated April 01, 2022

Record deactivated on April 01, 2022

🟢
Initial NPI Registration & Enumeration April 01, 2022

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1982344214
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: April 01, 2022
Last Update: May 27, 2022
Deactivation Date: April 01, 2022
Sole Proprietor: No

Mailing Address

Po Box 3988

Carbondale, IL 629023988

Phone: 6189933300

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.