Active NPI
East Tennessee Children's Hospital Association Inc.
Doing business as East Tennessee Children's Hospital Pediatric and Adolescent Gynecology
- Gynecology Physician
- Knoxville, TN
National Provider Identifier
1184247181
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gynecology Physician
- Legal business name
- EAST TENNESSEE CHILDREN'S HOSPITAL ASSOCIATION INC.
- Doing business as
- East Tennessee Children's Hospital Pediatric and Adolescent Gynecology
- Practice address
- 2100 Clinch Ave Ste 310
Knoxville, TN 37916-2220 - Phone
- (865) 546-0221
- Fax
- (866) 323-3153
- NPI assigned
- May 26, 2020
- Organization subpart
- Yes
- Parent organization
- EAST TENNESSEE CHILDREN'S HOSPITAL ASSOCIATION INC.
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Andrew Rosendahl
- Title
- Chief Financial Officer
- Phone
- (865) 541-8154
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gynecology Physician | 207VG0400X | Primary | ||
| Pediatrics Physician | 208000000X | |||
| Pediatric Nurse Practitioner | 363LP0200X |
Addresses
Primary practice location
2100 Clinch Ave Ste 310
Knoxville, TN 37916-2220
Mailing address
PO Box 15004
Knoxville, TN 37901-5004
Phone (865) 546-0221
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| Q057240 | Medicaid | TN |
Other names 1
- East Tennessee Children's Hospital Pediatric and Adolescent Gynecology
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 44D2189232 | Pediatric and Adolescent Gynecology | Certificate of waiver | Jul 27, 2026 |
National Provider Directory
National Provider Directory- Part of
- East Tennessee Children's
Member of 1
Organizations this organization is a member of, according to the National Provider Directory.
-
dba Dolly Parton Children's Hospital Psychology
- Clinical Child & Adolescent Psychologist
- Knoxville, TN
- NPI 1538339874
Member Of
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1590451200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1768348800000",
"number": "1184247181",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 15004",
"city": "KNOXVILLE",
"state": "TN",
"postal_code": "379015004",
"telephone_number": "865-546-0221",
"fax_number": "866-323-3153"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2100 CLINCH AVE STE 310",
"city": "KNOXVILLE",
"state": "TN",
"postal_code": "379162220",
"telephone_number": "865-546-0221",
"fax_number": "866-323-3153"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "EAST TENNESSEE CHILDREN'S HOSPITAL ASSOCIATION INC.",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "EAST TENNESSEE CHILDREN'S HOSPITAL ASSOCIATION INC.",
"enumeration_date": "2020-05-26",
"last_updated": "2026-01-14",
"certification_date": "2026-01-14",
"status": "A",
"authorized_official_last_name": "ROSENDAHL",
"authorized_official_first_name": "ANDREW",
"authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
"authorized_official_telephone_number": "865-541-8154"
},
"taxonomies": [
{
"code": "207VG0400X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Obstetrics & Gynecology, Gynecology",
"state": null,
"license": null,
"primary": true
},
{
"code": "208000000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Pediatrics",
"state": null,
"license": null,
"primary": false
},
{
"code": "363LP0200X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Nurse Practitioner, Pediatrics",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "Q057240",
"state": "TN"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "East Tennessee Children's Hospital Pediatric and Adolescent Gynecology",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Knoxville, TN
- East Tennesse Urology Specialists
- East Tennessee Allergy PC (Jeffrey L Schlactus MD)
- East Tennessee Cardiovascular Surgery Group, P.C
- East Tennessee Children's Hospital Association Inc. (Children's Neurology)
- East Tennessee Children's Hospital Association Inc. (Dolly Parton Children's Hospital Neurodevelopmental and Autism Center)
- East Tennessee Children's Hospital Association Inc. (East Tennessee Children's Hospital Pediatric Infectious Disease)
- East Tennessee Children's Hospital Association Inc. (Dolly Parton Children's Hospital Main Campus Pediatrics)
- East Tennessee Children's Hospital Association, Inc (ETCH Comprehensive Medication Management Services)
- East Tennessee Children's Hospital Association, Inc. (Dolly Parton Children's Hospital Plastic and Reconstructive Surgery)
- East Tennessee Children's Hospital Association, Inc. (Dolly Parton Children's Hospital Sleep Medicine)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.