EAST TENNESSEE CHILDREN'S HOSPITAL PRIMARY CARE CENTER, INC. (NPI# 1194348383) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194348383 |
| Entity Type | Organization |
| Organization Name | EAST TENNESSEE CHILDREN'S HOSPITAL PRIMARY CARE CENTER, INC. |
| Other Organization Name | CLAIBORNE COUNTY PEDIATRICS |
| Practice Address |
424 N Broad St Ste B New Tazewell TN 37825-6606 |
| Mailing Address |
Po Box 15004 Knoxville TN 37901-5004 |
| Practice Telephone | 4232593701 |
| Practice Fax Number | 8669545783 |
| Mailing Telephone | 8655418895 |
| Mailing Fax Number | 8656334808 |
| Enumeration Date | 2020-05-21 |
| Last Update Date | 2020-11-03 |
| Authorized Official Name | MARK B MASON (REGIONAL ADMINISTRATOR) |
| Authorized Official Telephone | 8655418053 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TN | Q057244 | 05 |
| Other Name | Type Code |
|---|---|
| Claiborne County Pediatrics | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457557134 | East Tennessee Children's Hospital Primary Care Center, Inc. | Pediatrics | 2130 N Charles G Seivers Blvd Ste 4, Clinton, TN 37716-6705 | 2007-06-21 |
| 1922203108 | East Tennessee Children's Hospital Primary Care Center, Inc. | Clinic/Center | 611 22nd Street, Knoxville, TN 37916 | 2007-06-18 |
| 1538364716 | East Tennessee Children's Hospital Primary Care Center, Inc. | Clinic/Center | 1921 Topside Road, Louisville, TN 37777 | 2007-06-18 |
| 1417152695 | East Tennessee Children's Hospital Primary Care Center, Inc. | Clinic/Center | 4529 Asheville Highway, Knoxville, TN 37914 | 2007-06-18 |
| 1306041587 | East Tennessee Children's Hospital Primary Care Center, Inc. | Clinic/Center | 1341 Branton Boulevard #102, Knoxville, TN 37922 | 2007-06-18 |
| 1265637441 | East Tennessee Children's Hospital Primary Care Center, Inc. | Nurse Practitioner | 125 Mountain View Dr Ste 200, Vonore, TN 37885-2666 | 2007-06-18 |
| 1235640467 | East Tennessee Children's Hospital Primary Care Center, Inc. | Clinic/Center | 10857 Hardin Valley Rd, Knoxville, TN 37932-1410 | 2017-10-16 |
| 1194109926 | East Tennessee Children's Hospital Primary Care Center, Inc. | Pediatrics | 1025 Childrens Way, Knoxville, TN 37922-7713 | 2015-07-10 |
| 1548466220 | East Tennessee Children's Hospital Primary Care Center, Inc. | Clinic/Center | 4600 Asheville Hwy, Knoxville, TN 37914-3665 | 2007-06-21 |
| 1366648040 | East Tennessee Children's Hospital Primary Care Center, Inc. | Pediatrics | 2221 Jacksboro Pike Ste C4, La Follette, TN 37766-3007 | 2007-06-21 |
| Street Address |
424 N BROAD ST STE B |
| City | NEW TAZEWELL |
| State | TN |
| Zip Code | 37825-6606 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225566953 | Justin Wade Widner | Pediatrics | 424 N Broad St Ste B, New Tazewell, TN 37825-6606 | 2017-05-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801131610 | Emma Hernandez Tenerife | Physical Therapist | 505 Buchanan Road, New Tazewell, TN 37825 | 2012-12-05 |
| 1295959021 | Melvin Keith Donesky | Dentist | 212 Forrest Ave., New Tazewell, TN 37825 | 2007-04-12 |
| 1962533059 | Lisa Ann Mayes | Case Manager/Care Coordinator | 1596 Highway 33 South, New Tazewell, TN 37825 | 2007-03-08 |
| 1679505937 | James P Crutchfield | Optometrist | 409 N Broad St, New Tazewell, TN 37825 | 2006-07-07 |
| 1497257984 | Selena Frazier | Speech-Language Pathologist | 902 Buchanan Rd, New Tazewell, Tn, TN 37825 | 2018-03-01 |
| 1891211165 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 915 Main St, New Tazewell, TN 37825 | 2017-08-18 |
| 1083169171 | Haley Henard Debusk | Physician Assistant | 424 N. Broad Street, New Tazwell, Tazewell, TN 37825 | 2016-08-18 |
| 1508154055 | Dr.melvin Donesky D.d.s. | Dentist | 212 Forrest Ave., New Tazewell, TN 37825 | 2011-07-19 |
| 1437488350 | William Herbert Brooks | Licensed Practical Nurse | 1596 Highway 33 South, New Tazewell, TN 37825 | 2009-12-24 |
| 1366680423 | Jessica Broyles | Dietitian, Registered | 620 Davis Dr, New Tazewell, TN 37825 | 2009-01-28 |
| Find all providers in zip 37825 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225566953 | Justin Wade Widner | Pediatrics | 424 N Broad St Ste B, New Tazewell, TN 37825-6606 | 2017-05-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366040131 | Mebe Tennessee | Pediatrics | 6339 Charlotte Pike # 1035, Nashville, TN 37209-2926 | 2020-10-14 |
| 1427679208 | Susan Ashley Stallings | Pediatrics | 5115 Woodland Hills Dr, Brentwood, TN 37027-5821 | 2020-05-03 |
| 1871112375 | Pediatric Medical Urgent Care Services Pllc | Pediatrics | 2249 Medical Center Pkwy Ste C&d, Murfreesboro, TN 37129-4279 | 2020-04-14 |
| 1508412347 | Amber Michelle Steeley | Pediatrics | 2713 Stone Trace Dr, Chattanooga, TN 37421-1194 | 2019-08-16 |
| 1083189377 | Rachel Ames | Pediatrics | 537 Stonecrest Pkwy Ste 201, Smyrna, TN 37167-6895 | 2018-10-12 |
| 1205333481 | Summit Medical Group,pllc | Pediatrics | 1341 Branton Blvd Ste 102, Knoxville, TN 37922-8521 | 2018-04-12 |
| 1952834558 | Jack Moore Whitehead | Pediatrics | 95 Seaboard Ln Ste 201, Brentwood, TN 37027-3040 | 2017-04-10 |
| 1134677818 | Dixie Swanson | Pediatrics | 2705 Daventry Dr, Maryville, TN 37804-6141 | 2016-09-12 |
| 1568817658 | Elizabeth Shawn Keiner | Pediatrics | 2200 Childrens Way # B319, Nashville, TN 37232-9760 | 2016-04-26 |
| 1922453190 | Rachel Michelle Lindsey | Pediatrics | 325 N State of Franklin Rd, Ground Floor, Etsu Physicians and Associates Pediatrics, Johnson City, TN 37604-6056 | 2016-04-25 |
| Find all providers with the same taxonomy | ||||
| City | NEW TAZEWELL |
| Zip Code | 37825 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.