EAST TENNESSEE CHILDREN'S HOSPITAL PRIMARY CARE CENTER, INC. (NPI# 1366647455) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366647455 |
| Entity Type | Organization |
| Organization Name | EAST TENNESSEE CHILDREN'S HOSPITAL PRIMARY CARE CENTER, INC. |
| Other Organization Name | OAK RIDGE PEDIATRICS |
| Practice Address |
145 E Vance Rd Oak Ridge TN 37830-6528 |
| Mailing Address |
Po Box 15004 Knoxville TN 37901-5004 |
| Practice Telephone | 8654824088 |
| Practice Fax Number | 8666742033 |
| Mailing Telephone | 8655418895 |
| Mailing Fax Number | 8656334808 |
| Enumeration Date | 2007-06-19 |
| Last Update Date | 2019-12-10 |
| Authorized Official Name | MARK B MASON (REGIONAL PRACTICE ADMINISTRATOR) |
| Authorized Official Telephone | 8655418053 |
| Is Organization Subpart | Y |
| Parent Organization Name | EAST TENNESSEE CHILDREN'S HOSPITAL PRIMARY CARE CENTER, INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2080S0010X |
Pediatrics Specialization: Sports Medicine |
Allopathic & Osteopathic Physicians | ||
| N | 261QP2300X |
Clinic/Center Specialization: Primary Care |
Ambulatory Health Care Facilities | ||
| N | 363L00000X | Nurse Practitioner | Physician Assistants & Advanced Practice Nursing Providers | ||
| N | 363LP0200X |
Nurse Practitioner Specialization: Pediatrics |
Physician Assistants & Advanced Practice Nursing Providers | ||
| N | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
Physician Assistants & Advanced Practice Nursing Providers | ||
| N | 363LP2300X |
Nurse Practitioner Specialization: Primary Care |
Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 208000000X | Pediatrics | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TN | Q002834 | 05 |
| Other Name | Type Code |
|---|---|
| Oak Ridge Pediatric Clinic | Doing Business As Name - Organization |
| Oak Ridge 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 |
| 1194348383 | East Tennessee Children's Hospital Primary Care Center, Inc. | Pediatrics | 424 N Broad St Ste B, New Tazewell, TN 37825-6606 | 2020-05-21 |
| 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 |
| Street Address |
145 E VANCE RD |
| City | OAK RIDGE |
| State | TN |
| Zip Code | 37830-6528 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629063342 | Paul Barongan | Specialist | 145 E Vance Rd, Oak Ridge, TN 37830-6528 | 2005-09-19 |
| 1740643162 | Hannah Elizabeth Cox | Pediatrics | 145 E Vance Rd, Oak Ridge, TN 37830-6528 | 2016-04-02 |
| 1053671115 | Sarah Elizabeth Eriksen | Pediatrics | 145 E Vance Rd, Oak Ridge, TN 37830-6528 | 2012-05-23 |
| 1891922191 | Samantha Dian Pollard | Pediatrics | 145 E Vance Rd, Oak Ridge, TN 37830-6528 | 2009-06-15 |
| 1588826051 | Matthew C Mccallister | Pediatrics | 145 E Vance Rd, Oak Ridge, TN 37830-6528 | 2008-06-26 |
| 1275736647 | Andrea N. Meadows | Pediatrics | 145 E Vance Rd, Oak Ridge, TN 37830-6528 | 2007-06-06 |
| 1477685311 | Nicole S Beavers | Nurse Practitioner | 145 E Vance Rd, Oak Ridge, TN 37830-6528 | 2007-03-09 |
| 1790816270 | Amy Wolz | Nurse Practitioner | 145 E Vance Rd, Oak Ridge, TN 37830-6528 | 2007-03-08 |
| 1356472849 | Karen J Wilkinson | Nurse Practitioner | 145 E Vance Rd, Oak Ridge, TN 37830-6528 | 2007-03-08 |
| 1083745459 | Mary J Cathey | Nurse Practitioner | 145 E Vance Rd, Oak Ridge, TN 37830-6528 | 2007-03-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194388702 | Oak Ridge Pharmacy | Pharmacy | 854 Main St W, Oak Ridge, TN 37830 | 2019-04-18 |
| 1134682693 | Mac's Pharmacy Oak Ridge, LLC | Pharmacy | 45 New York Avenue, Oak Ridge, TN 37830 | 2019-04-11 |
| 1689153876 | Tapuwa Martin Chikowore | Dentist | 377 S Illinois Ave, Oak Ridge, TN 37830 | 2018-08-09 |
| 1710475660 | Oak Ridge Smiles Dentistry, PC | Dentist | 377 S. Illinois Ave., Oak Ridge, TN 37830 | 2018-04-26 |
| 1417344763 | Heather Cupp | Social Worker | 723 Emory Valley Road, Oak Ridge, TN 37830 | 2015-04-23 |
| 1366701534 | Quality Care From The Heart | Preferred Provider Organization | 144 Newport Drive, Oak Ridge, TN 37830 | 2012-05-09 |
| 1578838223 | Second Chance Recovery In Faith, Inc | Community/Behavioral Health | 234 W Tennessee Ave, Oak Ridge, TN 37830 | 2012-03-14 |
| 1720364615 | Douglas Miller | Pharmacist | 1299 Oak Ridge Turnpike, Oak Ridge, TN 37830 | 2011-10-24 |
| 1619263852 | Namratha Reddy Vontela | Internal Medicine | 200 New York Ave Ste 200, Oak Ridge, TN 37830 | 2011-06-27 |
| 1356658165 | Fred Lewis Stephens | Social Worker | 150 E Division Rd Ste 10, Oak Ridge, TN 37830 | 2010-09-01 |
| Find all providers in zip 37830 | ||||
| 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 |
|---|---|---|---|---|
| 1205971462 | M Patricia Baran | Pediatrics | 31 Crest Lake Drive, Oak Ridge, NJ 07438-8984 | 2007-02-21 |
| 1124171160 | Forsyth Medical Group, LLC | Pediatrics | 2205 Oak Ridge Rd Ste Bb, Dba Forsyth Pediatrics Oakridge, Oak Ridge, NC 27310-8738 | 2007-01-22 |
| 1942226378 | Daphne Maples Mccoll | Pediatrics | 145 East Vance Rd, Oak Ridge, TN 37830 | 2006-07-15 |
| 1770528366 | Jason Troy Cheney | Pediatrics | 221 W Tyrone Rd, Oak Ridge, TN 37830-6500 | 2006-06-18 |
| 1497711709 | Clifford Dale James IIi | Pediatrics | 575 Oak Ridge Tpke, Ste 120, Oak Ridge, TN 37830-7100 | 2006-04-25 |
| 1801862354 | Laurie P Macdonald | Pediatrics | 2205 Oak Ridge Rd, Suite Aa-bb, Oak Ridge, NC 27310-8728 | 2006-02-24 |
| 1740643162 | Hannah Elizabeth Cox | Pediatrics | 145 E Vance Rd, Oak Ridge, TN 37830-6528 | 2016-04-02 |
| 1053671115 | Sarah Elizabeth Eriksen | Pediatrics | 145 E Vance Rd, Oak Ridge, TN 37830-6528 | 2012-05-23 |
| 1275848335 | Forsyth Medical Group, LLC | Pediatrics | 2205 Oak Ridge Rd, Suite Aa-bb, Oak Ridge, NC 27310-8728 | 2010-08-13 |
| 1902122625 | Forsyth Medical Group, LLC | Pediatrics | 2205 Oak Ridge Rd, Suite Aa-bb, Oak Ridge, NC 27310-8728 | 2010-04-20 |
| Find all providers in OAK RIDGE | ||||
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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.