East Tennessee Children'S Hospital Primary Care Center, INC.
Pediatrics in Vonore, TN. Organization (NPI-2).
NPI number1265637441
StatusActive
Last updated in NPPESNov 9, 2026
Details
- NPI
- 1265637441
- Entity type
- Organization (NPI-2)
- Legal business name
- East Tennessee Children'S Hospital Primary Care Center, INC.
- Organization subpart
- Yes
- Enumeration date
- Jun 18, 2007
- Certification date
- Nov 9, 2026
- Last updated
- Nov 9, 2026
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 208000000X | Pediatrics | – | – | Yes |
| 261QP2300X | Clinic/Center, Primary Care | – | – | |
| 363LF0000X | Nurse Practitioner, Family | – | – | |
| 363LP0200X | Nurse Practitioner, Pediatrics | – | – |
Other names
- Dolly Parton Children'S Hospital Vonore Pediatrics (Doing Business As)
Practice location
125 Mountain View Dr Ste 200Vonore, TN 37885-2666
Phone 423-884-2170 · Fax 866-330-9583
Mailing address
Po Box 50068Knoxville, TN 37950-0068
Phone 865-541-8895 · Fax 865-633-4808
Authorized official
Andrew Rosendahl
Chief Financial Officer
8655418154
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