NPIMap

Organization Active NPI

East Tennessee Children's Hospital Association, Inc.

Doing business as Dolly Parton Children's Hospital Surgery

  • Pediatric Surgery Physician
  • Knoxville, TN
National Provider Identifier
1639254972
Registry record updated Sep 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Surgery PhysicianTaxonomy code 2086S0120X
Legal business name
EAST TENNESSEE CHILDREN'S HOSPITAL ASSOCIATION, INC.
Doing business as
Dolly Parton Children's Hospital Surgery
East Tennessee Children's Hospital Pediatric Surgery
Practice address
2100 Clinch Ave Ste 510
Knoxville, TN 37916-2225
Phone
(865) 546-2131
Fax
(877) 821-0891
NPI assigned
Oct 26, 2006
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
Chief Financial Officer
Phone
(865) 541-8154

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208600000X
Pediatric Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2086S0120X Primary
Surgical Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363AS0400X

Addresses

Primary practice location

2100 Clinch Ave Ste 510
Knoxville, TN 37916-2225

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) 546-2131

Other identifiers 1

IdentifierTypeStateIssuer
3722556MedicaidTN

Other names 2

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

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040601000461 TN Part B Supplier - Clinic/Group Practice 6204817661 Receives reassigned benefits from 6 practitioners
10 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Oak Ridge, TN; Knoxville, TN; Cleveland, TN

Other NPIs on the same Medicare enrollment 9

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

National Provider Directory

National Provider Directory
Tax ID family
Dba Dolly Parton Children's Hospital Cardiology30 organizations share this tax ID, including this one
Part of
Dba Dolly Parton Children's Hospital Cardiology

Other organizations with this tax ID 29

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

View all 29

NPI Registry JSON

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

{
    "created_epoch": "1161820800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1788566400000",
    "number": "1639254972",
    "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 510",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379162225",
            "telephone_number": "865-546-2131",
            "fax_number": "877-821-0891"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1025 Childrens Way",
            "address_purpose": "LOCATION",
            "city": "Knoxville",
            "state": "TN",
            "postal_code": "379227713",
            "country_code": "US",
            "telephone_number": "865-546-2131",
            "fax_number": "877-821-0891",
            "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": "2006-10-26",
        "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": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2086S0120X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery, Pediatric Surgery",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant, Surgical",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3722556",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dolly Parton Children's Hospital Surgery",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "East Tennessee Children's Hospital Pediatric Surgery",
            "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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.