NPIMap

Organization Active NPI

East Tennessee Children's Primary Care Center, Inc.

Doing business as Dolly Parton Children's Hospital Vonore Pediatrics

  • Pediatrics Physician
  • Vonore, TN
National Provider Identifier
1265637441
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
Dolly Parton Children's Hospital Vonore Pediatrics
Vonore Pediatrics
Practice address
125 Mountain View Dr Ste 200
Vonore, TN 37885-2666
Phone
(423) 884-2170
Fax
(866) 330-9583
NPI assigned
Jun 18, 2007
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 4

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X Primary
Primary Care Clinic/Center 261QP2300X
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X
Pediatric Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP0200X

Addresses

Primary practice location

125 Mountain View Dr Ste 200
Vonore, TN 37885-2666

Mailing address

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

Other names 2

  • Dolly Parton Children's Hospital Vonore Pediatrics Doing business as
  • Vonore Pediatrics Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190411002554 TN Part B Supplier - Clinic/Group Practice 2961783626 Receives reassigned benefits from 5 practitioners
4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Knoxville, TN; Vonore, TN; Seymour, TN; Sevierville, TN; Oak Ridge, TN; Maryville, TN; La Follette, TN; Greeneville, TN…

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
East Tennessee Children's Primary Care Center Inc15 organizations share this tax ID, including this one
Part of
East Tennessee Children's Primary Care Center Inc

Other organizations with this tax ID 14

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

View all 14

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

125 Mountain View Dr
Ste 300
Vonore, TN 37885
Phone (423) 884-2170

Practitioners & affiliated clinicians

Practitioners 2

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": "1182124800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1788566400000",
    "number": "1265637441",
    "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": "125 MOUNTAIN VIEW DR STE 200",
            "city": "VONORE",
            "state": "TN",
            "postal_code": "378852666",
            "telephone_number": "423-884-2170",
            "fax_number": "866-330-9583"
        }
    ],
    "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": "2007-06-18",
        "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": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "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": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dolly Parton Children's Hospital Vonore Pediatrics",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Vonore Pediatrics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Vonore, 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 enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.