EAST TENNESSEE CHILDREN'S HOSPITAL ASSOCIATION, INC. (NPI# 1578648820) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578648820 |
| Entity Type | Organization |
| Organization Name | EAST TENNESSEE CHILDREN'S HOSPITAL ASSOCIATION, INC. |
| Other Organization Name | KNOXVILLE PEDIATRIC CARDIOLOGY |
| Practice Address |
2100 Clinch Ave Koppel Plaza, Ste 420 Knoxville TN 37916-2231 |
| Mailing Address |
Po Box 15004 Knoxville TN 37901-5004 |
| Practice Telephone | 8655220420 |
| Practice Fax Number | 8778016771 |
| Mailing Telephone | 8655418895 |
| Mailing Fax Number | 8656334808 |
| Enumeration Date | 2006-10-26 |
| 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 ASSOCIATION, INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208000000X | Pediatrics | Allopathic & Osteopathic Physicians | ||
| N | 261QM2500X |
Clinic/Center Specialization: Medical Specialty |
Ambulatory Health Care Facilities | ||
| Y | 2080P0202X |
Pediatrics Specialization: Pediatric Cardiology |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TN | 3717716 | 05 |
| Other Name | Type Code |
|---|---|
| Knoxville Pediatric Cardiology | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043855604 | East Tennessee Children's Hospital Association, Inc. | Surgery | 207 E Emory Rd, Powell, TN 37849-4047 | 2019-11-07 |
| 1609388438 | East Tennessee Children's Hospital Association, Inc. | Clinic/Center | 1060 Peerless Xing Nw Ste 100, Cleveland, TN 37312-3785 | 2017-11-02 |
| 1184247181 | East Tennessee Children's Hospital Association, Inc. | Pediatrics | 2100 Clinch Ave Ste 130, Knoxville, TN 37916-2224 | 2020-05-26 |
| 1396380648 | East Tennessee Children's Hospital Association, Inc. | Pediatrics | 1025 Childrens Way, Knoxville, TN 37922-7713 | 2019-11-11 |
| 1477941375 | East Tennessee Children's Hospital Association, Inc. | Dietitian, Registered | 2018 Clinch Ave, South Tower 2nd Floor, Knoxville, TN 37916-2301 | 2014-12-30 |
| 1194156992 | East Tennessee Children's Hospital Association, Inc. | Clinic/Center | 1025 Childrens Way, Knoxville, TN 37922-7713 | 2013-12-03 |
| 1588094494 | East Tennessee Children's Hospital Association, Inc. | Pediatrics | 120 Suburban Rd Ste 203, Knoxville, TN 37923-5592 | 2013-11-14 |
| 1093016289 | East Tennessee Children's Hospital Association, Inc. | Home Infusion | 11227 W Point Dr, Farragut, TN 37934-2838 | 2010-11-04 |
| 1770722688 | East Tennessee Children's Hospital Association, Inc. | Clinic/Center | 2100 Clinch Ave Ste 130, Knoxville, TN 37916-2224 | 2009-02-17 |
| 1538339874 | East Tennessee Children's Hospital Association, Inc. | Psychologist | 2100 Clinch Ave Ste 220, Knoxville, TN 37916-2298 | 2008-03-03 |
| Street Address |
2100 CLINCH AVE KOPPEL PLAZA, STE 420 |
| City | KNOXVILLE |
| State | TN |
| Zip Code | 37916-2231 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669432761 | Carol L Fowler | Surgery | 2100 Clinch Ave, Ste 430, Knoxville, TN 37916 | 2006-03-24 |
| 1679003461 | Jenny R Stevens | Nurse Practitioner | 2100 Clinch Ave, Suite 110, Knoxville, TN 37916 | 2017-06-14 |
| 1861514549 | Pediatric Endocrinology | Specialist | 2100 Clinch Ave, Ste 140, Knoxville, TN 37916 | 2007-04-04 |
| 1457402216 | Allyson D Schmitt | Ophthalmology | 2100 Clinch Ave, Suite 400 Koppel Plaza, Knoxville, TN 37916 | 2007-01-16 |
| 1174601090 | David Matthew Hurst | Pediatrics | 2100 Clinch Ave, Koppel Plaza, Ste 420, Knoxville, TN 37916-2231 | 2006-11-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477151322 | Chelsea Raye Tanner | Registered Nurse | American Anesthesiology of Tennessee, 501 20th Street, Suite 606, Knoxville, TN 37916 | 2020-10-13 |
| 1003473372 | Mary Katrina Quist Rouse | Nurse Practitioner | 2100 Clinch Ave Ste 330, Knoxville, TN 37916 | 2019-05-22 |
| 1457881724 | Leslie Lynette Taylor | Physical Medicine & Rehabilitation | 2120 Highland Avenue, Knoxville, TN 37916 | 2017-06-19 |
| 1235547423 | Publix Tennessee LLC | Durable Medical Equipment & Medical Supplies | 2429 University Commons Way, Knoxville, TN 37916 | 2014-07-31 |
| 1801182340 | Jessica Lee Sheah | Psychiatry & Neurology | 2100 W Clinch Avenue, Suite 210, Knoxville, TN 37916 | 2011-06-23 |
| 1326203548 | Bradley Jason Davis | Internal Medicine | 1819 Clinch Ave Ste 114, Knoxville, TN 37916 | 2008-07-28 |
| 1003012782 | East Tennessee Children's Hospital Association, Inc | Clinic/Center | 2100 West Clinch Avenue, Suite 510, Knoxville, TN 37916 | 2007-06-21 |
| 1922203108 | East Tennessee Children's Hospital Primary Care Center, Inc. | Clinic/Center | 611 22nd Street, Knoxville, TN 37916 | 2007-06-18 |
| 1699825984 | Orthodontic Design By Michael Sawaf | Dentist | 2220 White Ave, Knoxville, TN 37916 | 2007-01-11 |
| 1427115096 | Deborah Lynne Maples | Physical Therapy Assistant | Nhc Ft Sanders 2120 Highland Ave, Knoxville, TN 37916 | 2007-01-03 |
| Find all providers in zip 37916 | ||||
| Taxonomy Code | 2080P0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Pediatric Cardiology |
| A pediatric cardiologist provides comprehensive care to patients with cardiovascular problems. This specialist is skilled in selecting, performing and evaluating the structural and functional assessment of the heart and blood vessels, and the clinical evaluation of cardiovascular disease. |
| 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/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) was provided by the American Osteopathic Board of Pediatrics. The Certification is no longer offered. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003992686 | Nisha K Surenderanath | Pediatrics | 2100 Clinch Ave Ste 420, Knoxville, TN 37916-2231 | 2006-10-27 |
| 1265666747 | East Tennessee Pediatric Cardiology, P.C. | Pediatrics | 2001 Laurel Ave, Suite Ng4, Knoxville, TN 37916-1810 | 2009-05-12 |
| 1013091123 | Michael R Liske | Pediatrics | 2001 Laurel Ave, Suite Ng4, Knoxville, TN 37916-1810 | 2006-10-25 |
| 1124072095 | Sumeet K. Sharma | Pediatrics | 2100 W Clinch Ave, Koppel Plaza, Ste 420, Knoxville, TN 37916-2219 | 2006-05-22 |
| 1598744336 | Jeffory Glenn Jennings | Pediatrics | 2100 W Clinch Ave, Koppel Plaza, Ste 420, Knoxville, TN 37916-2219 | 2006-01-11 |
| 1356320311 | Yvonne A Bremer | Pediatrics | 2001 Laurel Ave, Suite Ng4, Knoxville, TN 37916-1810 | 2006-01-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851766760 | Jami Shakibi | Pediatrics | 812 Cobble Cv, Nashville, TN 37211-7934 | 2015-12-03 |
| 1275970048 | Benjamin Acheampong | Pediatrics | 3601, Nashville, TN 37232-0001 | 2013-06-03 |
| 1053758516 | Nicole Kristen Perry | Pediatrics | 330 23rd Ave N Ste 550, Nashville, TN 37203-1706 | 2013-05-23 |
| 1578856985 | Jerry Don Walkup Jr. | Pediatrics | 2312 Knob Creek Rd Ste 208, Johnson City, TN 37604-2367 | 2011-05-17 |
| 1740216514 | Nancy Ann Chase | Pediatrics | 805 Estate Pl Ste 1, Memphis, TN 38120-0647 | 2006-06-24 |
| 1194772178 | Gerald Johnson | Pediatrics | 6148 Lee Hwy Ste 206, Chattanooga, TN 37421 | 2006-05-27 |
| 1376533489 | Ashish B Madhok | Pediatrics | 2312 Knob Creek Rd, Suite208, Johnson City, TN 37604-2367 | 2005-10-28 |
| 1679560288 | James K Stamps | Pediatrics | 80 Humphreys Center, Suite 230, Memphis, TN 38120 | 2005-09-29 |
| 1548255276 | Fred S Lamb | Pediatrics | 5111 Dot, 2200 Childrens Way, Nashville, TN 37232-0001 | 2005-09-19 |
| 1679126056 | Knoxville Pediatric Cardiology Morristown | Pediatrics | 1817 W Morris Blvd, Morristown, TN 37813-2837 | 2019-07-24 |
| Find all providers with the same taxonomy | ||||
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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.