NPIMap

Organization Active NPI

East Tennessee Children's Primary Care Center, Inc.

Doing business as Clinton Pediatrics

  • Pediatrics Physician
  • Clinton, TN
National Provider Identifier
1457557134
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
Clinton Pediatrics
Dolly Parton Children's Hospital Clinton Pediatrics
Practice address
2130 N Charles G Seivers Blvd Ste 4
Clinton, TN 37716-6705
Phone
(865) 457-4044
Fax
(866) 699-4833
NPI assigned
Jun 21, 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 3

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

Addresses

Primary practice location

2130 N Charles G Seivers Blvd Ste 4
Clinton, TN 37716-6705

Mailing address

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

Other names 2

  • Clinton Pediatrics Doing business as
  • Dolly Parton Children's Hospital Clinton 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
44D0311248East TN Children's Hosp Primary Care Center, Inc2130 N Charles Seivers Blvd, Suite 4, Clinton, TN 37716Certificate of waiverApr 20, 2028

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

NPI Registry JSON

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

{
    "created_epoch": "1182384000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1788566400000",
    "number": "1457557134",
    "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": "2130 N CHARLES G SEIVERS BLVD STE 4",
            "city": "CLINTON",
            "state": "TN",
            "postal_code": "377166705",
            "telephone_number": "865-457-4044",
            "fax_number": "866-699-4833"
        }
    ],
    "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": "2007-06-21",
        "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": "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": "363LP0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Clinton Pediatrics",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Dolly Parton Children's Hospital Clinton Pediatrics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Clinton, 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.