EAST TENNESSEE CHILDREN'S HOSPITAL PRIMARY CARE CENTER, INC. (NPI# 1457557134) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457557134 |
| Entity Type | Organization |
| Organization Name | EAST TENNESSEE CHILDREN'S HOSPITAL PRIMARY CARE CENTER, INC. |
| Other Organization Name | CLINTON PEDIATRICS |
| Practice Address |
2130 N Charles G Seivers Blvd Ste 4 Clinton TN 37716-6705 |
| Mailing Address |
Po Box 15004 Knoxville TN 37901-5004 |
| Practice Telephone | 8654574044 |
| Practice Fax Number | 8666994833 |
| Mailing Telephone | 8655418895 |
| Mailing Fax Number | 8656334808 |
| Enumeration Date | 2007-06-21 |
| Last Update Date | 2019-12-10 |
| Authorized Official Name | MARK B MASON (REGIONAL PRACTICE ADMINISTRATOR) |
| Authorized Official Telephone | 8655418053 |
| Is Organization Subpart | Y |
| Parent Organization Name | EAST TENNESSEE CHILDREN'S HOSPITAL PRIMARY CARE CENTER, INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2080S0010X |
Pediatrics Specialization: Sports Medicine |
Allopathic & Osteopathic Physicians | ||
| N | 261QP2300X |
Clinic/Center Specialization: Primary Care |
Ambulatory Health Care Facilities | ||
| N | 363L00000X | Nurse Practitioner | Physician Assistants & Advanced Practice Nursing Providers | ||
| N | 363LP0200X |
Nurse Practitioner Specialization: Pediatrics |
Physician Assistants & Advanced Practice Nursing Providers | ||
| N | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
Physician Assistants & Advanced Practice Nursing Providers | ||
| N | 363LP2300X |
Nurse Practitioner Specialization: Primary Care |
Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 208000000X | Pediatrics | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TN | Q002835 | 05 |
| Other Name | Type Code |
|---|---|
| Clinton Pediatric Clinic | Doing Business As Name - Organization |
| Clinton Pediatrics | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922203108 | East Tennessee Children's Hospital Primary Care Center, Inc. | Clinic/Center | 611 22nd Street, Knoxville, TN 37916 | 2007-06-18 |
| 1538364716 | East Tennessee Children's Hospital Primary Care Center, Inc. | Clinic/Center | 1921 Topside Road, Louisville, TN 37777 | 2007-06-18 |
| 1417152695 | East Tennessee Children's Hospital Primary Care Center, Inc. | Clinic/Center | 4529 Asheville Highway, Knoxville, TN 37914 | 2007-06-18 |
| 1306041587 | East Tennessee Children's Hospital Primary Care Center, Inc. | Clinic/Center | 1341 Branton Boulevard #102, Knoxville, TN 37922 | 2007-06-18 |
| 1265637441 | East Tennessee Children's Hospital Primary Care Center, Inc. | Nurse Practitioner | 125 Mountain View Dr Ste 200, Vonore, TN 37885-2666 | 2007-06-18 |
| 1194348383 | East Tennessee Children's Hospital Primary Care Center, Inc. | Pediatrics | 424 N Broad St Ste B, New Tazewell, TN 37825-6606 | 2020-05-21 |
| 1235640467 | East Tennessee Children's Hospital Primary Care Center, Inc. | Clinic/Center | 10857 Hardin Valley Rd, Knoxville, TN 37932-1410 | 2017-10-16 |
| 1194109926 | East Tennessee Children's Hospital Primary Care Center, Inc. | Pediatrics | 1025 Childrens Way, Knoxville, TN 37922-7713 | 2015-07-10 |
| 1548466220 | East Tennessee Children's Hospital Primary Care Center, Inc. | Clinic/Center | 4600 Asheville Hwy, Knoxville, TN 37914-3665 | 2007-06-21 |
| 1366648040 | East Tennessee Children's Hospital Primary Care Center, Inc. | Pediatrics | 2221 Jacksboro Pike Ste C4, La Follette, TN 37766-3007 | 2007-06-21 |
| Street Address |
2130 N CHARLES G SEIVERS BLVD STE 4 |
| City | CLINTON |
| State | TN |
| Zip Code | 37716-6705 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730650870 | Kellye Watkins Wilson | Dental Hygienist | 420 S. Charles Seivers Blvd, Clinton, TN 37716 | 2018-12-16 |
| 1326428087 | Sandra Ella Humphrey Mincey | Registered Nurse | Mcneeley Family Physicians, 110 Executive Park Drive, Clinton, TN 37716 | 2015-06-08 |
| 1598157224 | Susan Price Teffeteller | Nurse Practitioner | 159 Frank L Diggs Road, Clinton, TN 37716 | 2015-03-04 |
| 1710268065 | Jimmy Neil Mcbride | Pharmacist | 1130 North Charles G. Seivers Boulevard, Clinton Drug Store, Clinton, TN 37716 | 2011-08-31 |
| 1265684658 | K-va-t Food Stores, Inc. | Durable Medical Equipment & Medical Supplies | 507 South Charles Sevier Boulevard, Clinton, TN 37716 | 2008-10-16 |
| 1912186016 | Comprehensive Industrial Services Inc | Physical Therapist | 1107 Charles Seivers Blvd, Suite 2, Clinton, TN 37716 | 2007-10-25 |
| 1205039120 | Pamela H. Gross, Ph.d, P.C. | Psychologist | 1729 Dutch Valley Road, Clinton, TN 37716 | 2007-06-07 |
| 1396872057 | Health Care Inc | Pharmacy | 1130 N Charles Seivers Blvd, Clinton, TN 37716 | 2007-02-28 |
| 1346389889 | Kellie Gaetz | Physical Therapist | 1115 Charles Seivers Blvd, Suite 22, Clinton, TN 37716 | 2007-02-05 |
| 1396883955 | Phoenix Counseling Services, Inc. | Counselor | 729 Charles Seivers, Clinton, TN 37716 | 2007-02-02 |
| Find all providers in zip 37716 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811307010 | Nermeen Nadeem Baseer | Pediatrics | 1477 N 2000 W Ste C, Clinton, UT 84015-9099 | 2014-04-28 |
| 1881945475 | Lighthouse Pediatric & After Hours Clinic, Pa | Pediatrics | 501 Springridge Rd, Clinton, MS 39056-5633 | 2012-09-24 |
| 1700146909 | Jessica Hutchison Crowe | Pediatrics | 2130 N Charles Seivers Boulevard, Suite 4, Clinton, TN 37716-6705 | 2012-05-22 |
| 1932466257 | Ashley Jane Jenkins | Pediatrics | 500 Plaza Cir Ste J, Clinton, SC 29325-7559 | 2012-04-12 |
| 1154633535 | Ejeehi Umobuarie | Pediatrics | 341 S 28th St, Clinton, OK 73601-3701 | 2010-07-13 |
| 1811083785 | Louisa Emefa Lawson | Pediatrics | 210 Clinton Blvd, Clinton, MS 39056-5126 | 2006-10-05 |
| 1902917206 | Jennifer K. Myers | Pediatrics | 539c Highway 80 W, Clinton, MS 39056-4193 | 2006-08-31 |
| 1447262878 | Christina Kay Neeley | Pediatrics | 500 Plaza Cir, Suite J, Clinton, SC 29325-7559 | 2006-08-13 |
| 1235166489 | Krishna Patel | Pediatrics | 40 Pittstown Road, Hunterdon Developmental Center, Clinton, NJ 08809-4008 | 2006-06-26 |
| 1083652630 | Piedmont Pediatrics of Laurens | Pediatrics | 996 Medical Ridge Road, Clinton, SC 29325 | 2006-06-04 |
| Find all providers in CLINTON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.