EAST TENNESSEE CHILDREN'S HOSPITAL PRIMARY CARE CENTER, INC. (NPI# 1790980977) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790980977 |
| Entity Type | Organization |
| Organization Name | EAST TENNESSEE CHILDREN'S HOSPITAL PRIMARY CARE CENTER, INC. |
| Other Organization Name | SEYMOUR PEDIATRIC CLINIC |
| Practice Address |
11616 Chapman Hwy Seymour TN 37865-5046 |
| Mailing Address |
Po Box 15004 Knoxville TN 37901-5004 |
| Practice Telephone | 8655793720 |
| Practice Fax Number | 8664068173 |
| Mailing Telephone | 8655418895 |
| Mailing Fax Number | 8656334808 |
| Enumeration Date | 2007-06-18 |
| 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 | 261QP2300X |
Clinic/Center Specialization: Primary Care |
Ambulatory Health Care Facilities | ||
| Y | 208000000X | Pediatrics | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TN | Q002824 | 05 |
| Other Name | Type Code |
|---|---|
| Pediatric Clinic Seymour | Doing Business As Name - Organization |
| Pediatric Clinic-Seymour | Doing Business As Name - Organization |
| Seymour Pediatric Clinic | 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 |
11616 CHAPMAN HWY |
| City | SEYMOUR |
| State | TN |
| Zip Code | 37865-5046 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609857358 | Frederick William Hodge | Pediatrics | 11616 Chapman Hwy, Seymour, TN 37865-5046 | 2005-11-09 |
| 1912365800 | Kelsey Ann May | Nurse Practitioner | 11616 Chapman Hwy, Seymour, TN 37865-5046 | 2016-02-05 |
| 1912257502 | Stephanie Lynn Gorman | Pediatrics | 11616 Chapman Hwy, Seymour, TN 37865-5046 | 2012-09-12 |
| 1740483213 | Laura Michelle Asbury | Pediatrics | 11616 Chapman Hwy, Seymour, TN 37865-5046 | 2007-06-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790285492 | Southeast Behavioral Services | Behavioral Analyst | 10721 Chapman Hwy Ste 22, Seymour, TN 37865 | 2018-02-19 |
| 1932645884 | Emma Love Gilmartin | Physician Assistant | 11606 Chapman Hwy Ste 2, Seymour, TN 37865 | 2017-01-17 |
| 1295065209 | Angela Kay Phifer | Acupuncturist | 10339 Chapman Hwy, Unit 2, Seymour, TN 37865 | 2010-01-14 |
| 1154596286 | Southeast Oral Surgery PC | Dentist | 11548 Chapman Hwy, Seymour, TN 37865 | 2008-04-29 |
| 1639358278 | Marta Finnegan | Case Manager/Care Coordinator | 1016 I.c. King Rd, Seymour, TN 37865 | 2007-10-31 |
| 1053590695 | Mary D Headrick | Registered Nurse | 1016 I. C. King Rd, Brookhaven Retreat, Seymour, TN 37865 | 2007-10-31 |
| 1225217706 | Melissa L Blaque | Case Manager/Care Coordinator | 1016 I.c. King Rd., Brookhaven Retreat, Seymour, TN 37865 | 2007-10-31 |
| 1841479318 | Ilene L Graham | Licensed Practical Nurse | 1061 I.c. King Rd., Brookhaven Retreat, Seymour, TN 37865 | 2007-10-31 |
| 1851597272 | Bethany Ann Thomas | Dentist | 119 Maryville Highway, Suite B, Seymour, TN 37865 | 2007-06-22 |
| 1881800175 | Eric D Lee | Pharmacist | 1125 Creekside Village Way, Seymour, TN 37865 | 2007-05-15 |
| Find all providers in zip 37865 | ||||
| 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 |
|---|---|---|---|---|
| 1922349596 | Lisa Marie Lindsay Snow | Pediatrics | Schneck Pediatrics, 411 West Tipton Street, Seymour, IN 47274 | 2013-03-07 |
| 1659316677 | David Enrique Mendez | Pediatrics | 212 Phoenix Ct, Suite 1, Seymour, TN 37865-3908 | 2006-06-17 |
| 1811978554 | Anil Harsh | Pediatrics | 11021 Chapman Hwy, Seymour, TN 37865 | 2005-11-09 |
| 1609857358 | Frederick William Hodge | Pediatrics | 11616 Chapman Hwy, Seymour, TN 37865-5046 | 2005-11-09 |
| 1962406405 | Courtney Burns Kleber | Pediatrics | 1171 W Tipton St, Ste D, Seymour, IN 47274-2794 | 2005-06-13 |
| 1053760728 | Courtney Elizabeth Glos | Pediatrics | 411 W Tipton St, Seymour, IN 47274-2363 | 2016-06-03 |
| 1912257502 | Stephanie Lynn Gorman | Pediatrics | 11616 Chapman Hwy, Seymour, TN 37865-5046 | 2012-09-12 |
| 1659557825 | Toni Hsi Hao Chu | Pediatrics | 201 Stadium Dr, Seymour, TX 76380-2377 | 2008-01-17 |
| 1740483213 | Laura Michelle Asbury | Pediatrics | 11616 Chapman Hwy, Seymour, TN 37865-5046 | 2007-06-11 |
| 1538256003 | Seymour Pediatrics, LLC | Pediatrics | 1171 W Tipton St, Suite D, Seymour, IN 47274-2793 | 2006-10-06 |
| Find all providers in SEYMOUR | ||||
Please comment or provide details below to improve the information on EAST TENNESSEE CHILDREN'S HOSPITAL PRIMARY CARE CENTER, INC..
| 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.