OrganizationActive
East Tennessee Children'S Hospital Association Inc.
NPI 1639254972 · Pediatric Surgery Physician · Knoxville, TN
Provider details
- NPI number
- 1639254972
- Entity type
- Organization
- Primary specialty
- Pediatric Surgery PhysicianAllopathic & Osteopathic Physicians
- Parent organization
- East Tennessee Children'S Hospital Association Inc.
- Organization subpart
- Yes
- Authorized official
- Andrew Rosendahl, Chief Financial Officer(865) 541-8154
Specialties & taxonomies
Allopathic & Osteopathic Physicians
- Surgery Physician208600000X
Allopathic & Osteopathic Physicians
- Surgical Physician Assistant363AS0400X
Physician Assistants & Advanced Practice Nursing Providers
Profile Score
Detailed profile(99/100 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
4 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 Avenue Suite 510
Knoxville, TN 37916-2225
Phone: (865) 546-2131
Fax: (877) 821-0891
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 Surgery
Additional practice locations (3)
- 1025 Childrens WayKnoxville, TN 37922-7713Phone: (865) 546-2131Fax: (877) 821-0891
- 207 E Emory RdPowell, TN 37849-4047Phone: (865) 546-2131Fax: (877) 821-0891
- 502 Winfield Dunn PkwySevierville, TN 37876-5509Phone: (865) 546-2131Fax: (877) 821-0891
Registry dates
- Enumerated
- 2006-10-26
- 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.