Organization Active NPI

East Tennessee Children's Hospital Association, Inc.

Doing business as Dolly Parton Children's Hospital Urology

  • Pediatric Urology Physician
  • Knoxville, TN
National Provider Identifier
1568581387
Registry record updated Sep 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Urology PhysicianTaxonomy code 2088P0231X
Legal business name
EAST TENNESSEE CHILDREN'S HOSPITAL ASSOCIATION, INC.
Doing business as
Dolly Parton Children's Hospital Urology
East Tennessee Children's Hospital Pediatric Urology
Practice address
2100 Clinch Ave Ste 310
Knoxville, TN 37916-2220
Phone
(865) 673-9315
Fax
(877) 850-9131
NPI assigned
Mar 29, 2007
Organization subpart
Yes
Parent organization
EAST TENNESSEE CHILDREN'S HOSPITAL ASSOCIATION, 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
Cfo
Phone
(865) 541-8154

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X
Pediatric Urology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2088P0231X Primary
Pediatric Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP0200X

Addresses

Primary practice location

2100 Clinch Ave Ste 310
Knoxville, TN 37916-2220

Mailing address

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

Other practice location 1

1025 Childrens Way
Knoxville, TN 37922-7713
Phone (865) 673-9315

Other identifiers 1

IdentifierTypeStateIssuer
3735949MedicaidTN

Other names 2

  • Dolly Parton Children's Hospital Urology Doing business as
  • East Tennessee Children's Hospital Pediatric Urology Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070330000116 TN Part B Supplier - Clinic/Group Practice 6800990847 Receives reassigned benefits from 1 practitioner
Practice locations: Knoxville, TN

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
44D1063671Tennessee Pediatric Urology PC2100 Clinch Avenue Ste 310, Knoxville, TN 37916Certificate of waiverJan 12, 2028

National Provider Directory

National Provider Directory
Part of
East Tennessee Children's

Locations

2018 Clinch Ave
Fl 2
Knoxville, TN 37916
Phone (865) 971-7400

2100 Clinch Ave
Ste 130
Knoxville, TN 37916
Phone (865) 546-3111

2018 Clinch Ave
#2
Knoxville, TN 37916
Phone (865) 522-0420

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1175126400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1788566400000",
    "number": "1568581387",
    "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": "2100 CLINCH AVE STE 310",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379162220",
            "telephone_number": "865-673-9315",
            "fax_number": "877-850-9131"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1025 Childrens Way",
            "address_purpose": "LOCATION",
            "city": "Knoxville",
            "state": "TN",
            "postal_code": "379227713",
            "country_code": "US",
            "telephone_number": "865-673-9315",
            "fax_number": "877-850-9131",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "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": "2007-03-29",
        "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": "CFO",
        "authorized_official_telephone_number": "865-541-8154"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2088P0231X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Urology, Pediatric Urology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "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": "3735949",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dolly Parton Children's Hospital Urology",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "East Tennessee Children's Hospital Pediatric Urology",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Knoxville, 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.
  • 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.