EAST TENNESSEE CHILDREN'S HOSPITAL PRIMARY CARE CENTER, INC. (NPI# 1659576825) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1659576825 |
| Entity Type | Organization |
| Organization Name | EAST TENNESSEE CHILDREN'S HOSPITAL PRIMARY CARE CENTER, INC. |
| Other Organization Name | NORTH KNOXVILLE PEDIATRICS |
| Practice Address |
1400 Dutch Valley Dr Knoxville TN 37918-1424 |
| Mailing Address |
Po Box 15004 Knoxville TN 37901-5004 |
| Practice Telephone | 8656891122 |
| Practice Fax Number | 8663403781 |
| Mailing Telephone | 8655418895 |
| Mailing Fax Number | 8656334808 |
| Enumeration Date | 2007-06-18 |
| Last Update Date | 2020-06-02 |
| 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 | 104100000X | Social Worker | Behavioral Health & Social Service Providers | ||
| N | 1041C0700X |
Social Worker Specialization: Clinical |
Behavioral Health & Social Service Providers | ||
| N | 261QP2300X |
Clinic/Center Specialization: Primary Care |
Ambulatory Health Care Facilities | ||
| N | 363L00000X | Nurse Practitioner | Physician Assistants & Advanced Practice Nursing Providers | ||
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
Physician Assistants & Advanced Practice Nursing Providers | ||
| N | 363LP0200X |
Nurse Practitioner Specialization: Pediatrics |
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 | Q002812 | 05 |
| Other Name | Type Code |
|---|---|
| Children's Primary Care Center | Doing Business As Name - Organization |
| North Knoxville Pediatrics | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457557134 | East Tennessee Children's Hospital Primary Care Center, Inc. | Pediatrics | 2130 N Charles G Seivers Blvd Ste 4, Clinton, TN 37716-6705 | 2007-06-21 |
| 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 |
| Street Address |
1400 DUTCH VALLEY DR |
| City | KNOXVILLE |
| State | TN |
| Zip Code | 37918-1424 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174506968 | Angel D Acevedo | Pediatrics | 1400 Dutch Valley Dr, Knoxville, TN 37918-1424 | 2005-11-25 |
| 1215442926 | Virginia Ewing Childs | Social Worker | 1400 Dutch Valley Dr, Knoxville, TN 37918-1424 | 2017-12-05 |
| 1205378213 | Amanda Brooke Cabage | Nurse Practitioner | 1400 Dutch Valley Dr, Knoxville, TN 37918-1424 | 2016-11-08 |
| 1356736086 | Carolyn Scarbrough | Registered Nurse | 1400 Dutch Valley Dr, Knoxville, TN 37918-1424 | 2015-03-31 |
| 1124329420 | Sandra D'nice Carden | Nurse Practitioner | 1400 Dutch Valley Dr, Knoxville, TN 37918-1424 | 2010-11-03 |
| 1508186818 | Heather Nicole Lopez | Pediatrics | 1400 Dutch Valley Dr, Knoxville, TN 37918-1424 | 2010-06-09 |
| 1306160312 | Grace Mcwhirter Lawley | Nurse Practitioner | 1400 Dutch Valley Dr, Knoxville, TN 37918-1424 | 2010-03-19 |
| 1699937862 | Amanda Jacquelyn Didolkar | Pediatrics | 1400 Dutch Valley Dr, Knoxville, TN 37918-1424 | 2008-06-30 |
| 1043420680 | Ashley Bateman | Counselor | 1400 Dutch Valley Dr, Knoxville, TN 37918-1424 | 2007-05-23 |
| 1295868990 | Angela Leigh Bell | Nurse Practitioner | 1400 Dutch Valley Dr, Knoxville, TN 37918-1424 | 2007-03-13 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639636145 | Samantha Fuhrmann | Physical Therapy Assistant | Beverly Park Place Health and Rehab, 5321 Beverly Park Circle, Knoxville, TN 37918 | 2019-02-21 |
| 1043701741 | Lauren Lea Wilson | Student in an Organized Health Care Education/Training Program | 4230 Homewood Rd, Knoxville, TN 37918 | 2018-05-29 |
| 1164790317 | Jennifer Young Brooks | Pharmacist | 5006 North Broadway, Knoxville, TN 37918 | 2011-12-02 |
| 1215213194 | Lu Miller | Pharmacist | 5006 N Broadway, Knoxville, TN 37918 | 2011-10-24 |
| 1326353475 | Lauren Joy Stone | Optometrist | 4829 N Broadway St Ste 103, Knoxville, TN 37918 | 2010-08-13 |
| 1699004531 | Larry Kyle Sowder | Dentist | 2944 Tazewell Pk, Ste #2, Knoxville, TN 37918 | 2009-12-23 |
| 1922233881 | Andrea' Lamar Farrior | Dentist | 2937 Essary Rd., Dr. Michael Edenfield, Knoxville, TN 37918 | 2009-05-21 |
| 1053558510 | Love-hope Academy | Counselor | 3826 Tiberius Rd Ste 315, Knoxville, TN 37918 | 2009-01-20 |
| 1497910293 | Diana Lynn Mccoy | Psychologist | 5019 Jacksboro Pike, Knoxville, TN 37918 | 2008-07-22 |
| 1740498088 | Kathleen M Riley | Pharmacist | K-mart Pharmacy #7460, 6906 Manardville Pike Ne, Knoxville, TN 37918 | 2007-05-18 |
| Find all providers in zip 37918 | ||||
| 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 |
|---|---|---|---|---|
| 1205333481 | Summit Medical Group,pllc | Pediatrics | 1341 Branton Blvd Ste 102, Knoxville, TN 37922-8521 | 2018-04-12 |
| 1942643853 | Jennifer Lynne Jaynes | Pediatrics | 10857 Hardin Valley Rd, Knoxville, TN 37932-1410 | 2013-04-10 |
| 1346510856 | Donald Eugene Lighter II | Pediatrics | 2120 River Sound Dr, Knoxville, TN 37922-5663 | 2012-01-01 |
| 1851536015 | Jennifer Leigh Damewood | Pediatrics | 1718 Saint Mary St Ste A, Knoxville, TN 37917-4518 | 2008-12-02 |
| 1316118714 | Pediatric Consultants At Cedar Bluff | Pediatrics | 9333 Park West Blvd Ste 104, Knoxville, TN 37923-4305 | 2008-03-13 |
| 1235294943 | Stanley S. Park | Pediatrics | 5300 Clinton Plaza Drive, Knoxville, TN 37912-3830 | 2006-12-22 |
| 1497845499 | Barbara Summers | Pediatrics | 2201 W Clinch Ave, Knoxville, TN 37916-2203 | 2006-10-13 |
| 1689764656 | Deborah Jones Christiansen | Pediatrics | 120 Suburban Rd Ste 203, Knoxville, TN 37923-5592 | 2006-10-13 |
| 1699860692 | David Sean Teaster | Pediatrics | 4741 Broadway, Knoxville, TN 37918 | 2006-10-04 |
| 1215037106 | Deborah Zimo | Pediatrics | 611 22nd St, Knoxville, TN 37916-2211 | 2006-09-22 |
| Find all providers in KNOXVILLE | ||||
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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.