Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

East Tennessee Children's Hospital Primary Care Center, Inc

Organization Pediatrics Physician · NPI 1366647455

East Tennessee Children's Hospital Primary Care Center, Inc is a Pediatrics Physician in Oak Ridge, Tennessee. Registered with an NPI since 2007.

In the registry since
2007
Specialties on file
4
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

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Practice location Address checks out

801 Oak Ridge Tpke
Oak Ridge, TN 37830-6916
Phone: (865) 482-4088
Fax: (866) 674-2033
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pediatrics Physician (primary) Taxonomy 208000000X
Pediatric Sports Medicine Physician Taxonomy 2080S0010X
Primary Care Clinic/Center Taxonomy 261QP2300X
Pediatric Nurse Practitioner Taxonomy 363LP0200X

Record details

NPI number1366647455
Entity typeOrganization (Type 2)
Organization subpartYes
Parent organizationEast Tennessee Children's Hospital Primary Care Center Inc
Authorized official Andrew Rosendahl — Chief Financial Officer · (865) 541-8154
Other names Oak Ridge Pediatrics
NPI enumeratedJune 19, 2007
Last updated in NPPESJanuary 14, 2026
Certification dateJanuary 14, 2026
Mailing addressPo Box 15004, Knoxville, TN 37901-5004

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