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Contact Information

EAST TENNESSEE CHILDREN'S HOSPITAL PRIMARY CARE CENTER, INC.
2221 JACKSBORO PIKE STE C4
LAFOLLETTE, TN37766-3007
 Phone: 423-566-3488
 Fax: 866-722-3453
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pediatrics

208000000X 37 Physician/Pediatric Medicine
 

Pediatrics

363LP0200X 50 Nurse Practitioner
 

Primary Care

261QP2300X
Indicates primary specialty

NPI Profile & details for EAST TENNESSEE CHILDREN'S HOSPITAL PRIMARY CARE CENTER, INC.

NPI # 1366648040
LBN Legal business name EAST TENNESSEE CHILDREN'S HOSPITAL PRIMARY CARE CENTER, INC.
Authorized official ANDREW ROSENDAHL - (CHIEF FINANCIAL OFFICER)
Entity Organization
Organization subpart 1 Yes
Enumeration date 06/21/2007
Last updated 01/14/2026 - About 5 months ago
Identifiers
TN Medicaid Q002836
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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