NPIMap

Organization Active NPI

East Tennessee Children's Primary Care Center, Inc.

Doing business as Claiborne County Pediatrics

  • Pediatrics Physician
  • Tazewell, TN
National Provider Identifier
1194348383
Registry record updated Sep 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
EAST TENNESSEE CHILDREN'S PRIMARY CARE CENTER, INC.
Doing business as
Claiborne County Pediatrics
Dolly Parton Children's Hospital Claiborne County Pediatrics
Practice address
1610 Tazewell Rd Ste 203
Tazewell, TN 37879-3648
Phone
(423) 259-3701
Fax
(866) 954-5783
NPI assigned
May 21, 2020
Last updated
Sep 5, 2026By the provider in NPPES
Organization subpart
Yes
Parent organization
EAST TENNESSEE CHILDREN'S PRIMARY CARE CENTER, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 5, 2026

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X NU Primary

Addresses

Primary practice location

1610 Tazewell Rd Ste 203
Tazewell, TN 37879-3648

Mailing address

PO Box 50068
Knoxville, TN 37950-0068
Phone (865) 541-8895

Other identifiers 1

IdentifierTypeStateIssuer
Q057244MedicaidTN

Other names 2

  • Claiborne County Pediatrics Doing business as
  • Dolly Parton Children's Hospital Claiborne County Pediatrics Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
44D2195724Claiborne County Pediatrics1610 Tazewell Road, Suite 203, Tazewell, TN 37879Certificate of waiverOct 11, 2026

National Provider Directory

National Provider Directory
Tax ID family
East Tennessee Children's Primary Care Center Inc14 organizations share this tax ID, including this one
Part of
East Tennessee Children's Primary Care Center Inc

Other organizations with this tax ID 13

Organizations that report the same tax identification number in the National Provider Directory.

View all 13

Locations

424 N Broad St
New Tazewell, TN 37825
Phone (423) 259-5700

424 N Broad St
Ste B
New Tazewell, TN 37825

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1590019200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1788566400000",
    "number": "1194348383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 50068",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379500068",
            "telephone_number": "865-541-8895",
            "fax_number": "865-633-4808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1610 TAZEWELL RD STE 203",
            "city": "TAZEWELL",
            "state": "TN",
            "postal_code": "378793648",
            "telephone_number": "423-259-3701",
            "fax_number": "866-954-5783"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST TENNESSEE CHILDREN'S PRIMARY CARE CENTER, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "EAST TENNESSEE CHILDREN'S PRIMARY CARE CENTER, INC.",
        "enumeration_date": "2020-05-21",
        "last_updated": "2026-09-05",
        "certification_date": "2026-09-05",
        "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": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q057244",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Claiborne County Pediatrics",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Dolly Parton Children's Hospital Claiborne County Pediatrics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tazewell, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 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.

Verify at the official NPI Registry.