OrganizationActive
East Tennessee Children'S Hospital Association Inc.
NPI 1568581387 · Pediatric Urology Physician · Knoxville, TN
Provider details
- NPI number
- 1568581387
- Entity type
- Organization
- Primary specialty
- Pediatric Urology PhysicianAllopathic & Osteopathic Physicians
- Parent organization
- East Tennessee Children'S Hospital Association Inc.
- Organization subpart
- Yes
- Authorized official
- Andrew Rosendahl, Cfo(865) 541-8154
Specialties & taxonomies
Allopathic & Osteopathic Physicians
- Pediatrics Physician208000000X
Allopathic & Osteopathic Physicians
- Pediatric Nurse Practitioner363LP0200X
Physician Assistants & Advanced Practice Nursing Providers
Profile Score
Detailed profile(94/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
2 documented practice locations
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
2100 Clinch Ave Ste 310
Knoxville, TN 37916-2220
Phone: (865) 673-9315
Fax: (877) 850-9131
Street-level locationGet directions
Mailing address
Po Box 15004
Knoxville, TN 37901-5004
Other names (DBA / former)
- Doing business as
- East Tennessee Children'S Hospital Pediatric Urology
Additional practice locations (1)
- 1025 Childrens WayKnoxville, TN 37922-7713Phone: (865) 673-9315Fax: (877) 850-9131
Registry dates
- Enumerated
- 2007-03-29
- Last updated
- 2025-12-30
- Certified
- 2025-12-30
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.