OrganizationActive
East Tennessee Children'S Hospital Primary Care Center, Inc.
NPI 1457557134 · Pediatrics Physician · Clinton, TN
Provider details
- NPI number
- 1457557134
- Entity type
- Organization
- Primary specialty
- Pediatrics PhysicianAllopathic & Osteopathic Physicians
- Parent organization
- East Tennessee Children'S Hospital Primary Care Center Inc.
- Organization subpart
- Yes
- Authorized official
- Andrew Rosendahl, Chief Financial Officer(865) 541-8154
Specialties & taxonomies
Allopathic & Osteopathic Physicians
- Pediatric Nurse Practitioner363LP0200X
Physician Assistants & Advanced Practice Nursing Providers
- Primary Care Clinic/Center261QP2300X
Ambulatory Health Care Facilities
Profile Score
Detailed profile(89/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
18 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
2130 N Charles G Seivers Blvd Ste 4
Clinton, TN 37716-6705
Phone: (865) 457-4044
Fax: (866) 699-4833
Street-level locationGet directions
Mailing address
Po Box 15004
Knoxville, TN 37901-5004
Other names (DBA / former)
- Doing business as
- Clinton Pediatrics
Registry dates
- Enumerated
- 2007-06-21
- Last updated
- 2026-01-14
- Certified
- 2026-01-14
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.