EAST TENNESSEE CHILDREN'S HOSPITAL ASSOCIATION, INC. (NPI# 1588094494) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588094494 |
| Entity Type | Organization |
| Organization Name | EAST TENNESSEE CHILDREN'S HOSPITAL ASSOCIATION, INC. |
| Other Organization Name | ETCH DEVELOPMENTAL BEHAVIORAL CENTER |
| Practice Address |
120 Suburban Rd Ste 203 Knoxville TN 37923-5592 |
| Mailing Address |
Po Box 15004 Knoxville TN 37901-5004 |
| Practice Telephone | 8656901464 |
| Practice Fax Number | 8779260521 |
| Mailing Telephone | 8655418895 |
| Mailing Fax Number | 8656334808 |
| Enumeration Date | 2013-11-14 |
| 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 ASSOCIATION, INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208000000X | Pediatrics | Allopathic & Osteopathic Physicians | ||
| N | 261QM2500X |
Clinic/Center Specialization: Medical Specialty |
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 | 363LP2300X |
Nurse Practitioner Specialization: Primary Care |
Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 2080P0006X |
Pediatrics Specialization: Developmental – Behavioral Pediatrics |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TN | Q002970 | 05 |
| Other Name | Type Code |
|---|---|
| East Tennessee Children's Hopital Developmental Behavioral Center | Doing Business As Name - Organization |
| East Tennessee Children's Hospital Developmental Behavioral Center | Doing Business As Name - Organization |
| ETCH Developmental Behavioral Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043855604 | East Tennessee Children's Hospital Association, Inc. | Surgery | 207 E Emory Rd, Powell, TN 37849-4047 | 2019-11-07 |
| 1609388438 | East Tennessee Children's Hospital Association, Inc. | Clinic/Center | 1060 Peerless Xing Nw Ste 100, Cleveland, TN 37312-3785 | 2017-11-02 |
| 1184247181 | East Tennessee Children's Hospital Association, Inc. | Pediatrics | 2100 Clinch Ave Ste 130, Knoxville, TN 37916-2224 | 2020-05-26 |
| 1396380648 | East Tennessee Children's Hospital Association, Inc. | Pediatrics | 1025 Childrens Way, Knoxville, TN 37922-7713 | 2019-11-11 |
| 1477941375 | East Tennessee Children's Hospital Association, Inc. | Dietitian, Registered | 2018 Clinch Ave, South Tower 2nd Floor, Knoxville, TN 37916-2301 | 2014-12-30 |
| 1194156992 | East Tennessee Children's Hospital Association, Inc. | Clinic/Center | 1025 Childrens Way, Knoxville, TN 37922-7713 | 2013-12-03 |
| 1093016289 | East Tennessee Children's Hospital Association, Inc. | Home Infusion | 11227 W Point Dr, Farragut, TN 37934-2838 | 2010-11-04 |
| 1770722688 | East Tennessee Children's Hospital Association, Inc. | Clinic/Center | 2100 Clinch Ave Ste 130, Knoxville, TN 37916-2224 | 2009-02-17 |
| 1538339874 | East Tennessee Children's Hospital Association, Inc. | Psychologist | 2100 Clinch Ave Ste 220, Knoxville, TN 37916-2298 | 2008-03-03 |
| 1669678348 | East Tennessee Children's Hospital Association, Inc. | Pediatrics | 2018 Clinch Ave, South Tower 2nd Floor, Knoxville, TN 37916-2301 | 2007-06-21 |
| Street Address |
120 SUBURBAN RD STE 203 |
| City | KNOXVILLE |
| State | TN |
| Zip Code | 37923-5592 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689764656 | Deborah Jones Christiansen | Pediatrics | 120 Suburban Rd Ste 203, Knoxville, TN 37923-5592 | 2006-10-13 |
| 1134525009 | Lauren Vannoy Johnson | Nurse Practitioner | 120 Suburban Rd Ste 203, Knoxville, TN 37923-5592 | 2014-11-05 |
| 1831514488 | Heather Ilana Polk | Nurse Practitioner | 120 Suburban Rd Ste 203, Knoxville, TN 37923-5592 | 2014-02-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114541240 | Chloe Morgan | Registered Nurse | Parkwest Blvd, Knoxville, TN 37923 | 2020-06-04 |
| 1215551346 | Kaylee Huskey | Registered Nurse | Park West Blvd, Knoxville, TN 37923 | 2020-06-04 |
| 1942849914 | American Brace & Limb Enterprise, LLC | Prosthetic/Orthotic Supplier | 9333 Parkwest Blvd., 103, Knoxville, TN 37923 | 2019-12-23 |
| 1619510690 | Stacia Working | Speech-Language Pathologist | 310 Corporate Dr, Ste 101, Knoxville, TN 37923 | 2019-10-23 |
| 1497242903 | Mary Ensminger Loomis | Speech-Language Pathologist | 118 N Peters Rd Ste 174, Knoxville, TN 37923 | 2018-04-19 |
| 1831699602 | Shaun Elizabeth Hoffman | Counselor | 311 Directors Dr, Knoxville, TN 37923 | 2018-02-17 |
| 1962948737 | East Tennessee Binocular Vision Center Pllc | Optometrist | 9051 Executive Park Dr., Ste. 400, Knoxvville, TN 37923 | 2017-01-17 |
| 1467815761 | Hearing Conservation Associates Inc | Audiologist | 9301 Parkwest Blvd B-3, Knoxville, TN 37923 | 2016-04-04 |
| 1710354725 | Independent Physical Therapy, LLC | Occupational Therapist | 8905 Town and Country Cir Ste 9, Knoxville, TN 37923 | 2015-08-25 |
| 1568863553 | Kathryn Faye Ledbetter | Registered Nurse | 9352 Park W Blvd, Knoxville, TN 37923 | 2014-09-09 |
| Find all providers in zip 37923 | ||||
| Taxonomy Code | 2080P0006X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Developmental – Behavioral Pediatrics |
| A developmental-behavioral specialist is a pediatrician with special training and experience who aims to foster understanding and promotion of optimal development of children and families through research, education, clinical care and advocacy efforts. This physician assists in the prevention, diagnosis, and management of developmental difficulties and problematic behaviors in children and in the family dysfunctions that compromise children's development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition changed, source changed, 3/26/2008: definition corrected] Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750650875 | Medical Education Assistance Corporation | Pediatrics | 252 Sam Jenkins Rd, Attn: Dr. H. Patrick Stern, Gray, TN 37615 | 2011-12-19 |
| 1629346580 | Medical Education Assistance Corporation | Pediatrics | 2891 Highway 11 E, Attn: Dr. H. Patrick Stern, Telford, TN 37690 | 2011-12-07 |
| 1477786473 | Centrosalud PC | Pediatrics | 2900 Kirby Road, Suite #11, Memphis, TN 38119 | 2009-08-25 |
| 1790905974 | John T Netterville Jr. | Pediatrics | The Attention & Behavior Clinic, 2001 Mallory Lane Ste 300, Franklin, TN 37067-8236 | 2007-04-27 |
| 1952354367 | Felicia Merriweather Knowles | Pediatrics | 2182 West St, Germantown, TN 38138-3829 | 2006-05-18 |
| 1215921226 | Ronald Rafael Espinal | Pediatrics | 711 Jefferson Ave, Memphis, TN 38105-5003 | 2005-09-06 |
| 1790102788 | Katelyn Rossow | Pediatrics | 2200 Children's Way, Monroe Carell Jr. Children's Hospital At Vanderbilt, Nashville, TN 37232 | 2014-03-27 |
| 1366785230 | Center for Developmental and Behavioral Pediatrics | Pediatrics | 6025 Lee Hwy, Ste. 447, Chattanooga, TN 37421-3099 | 2013-03-29 |
| 1912268608 | Jane Marie Martinez | Pediatrics | 1211 21st Ave S Ste 110, Nashville, TN 37212-2717 | 2012-05-30 |
| 1942577549 | Angela Ervin Stevens | Pediatrics | 4738 Walnut Grove Rd, Memphis, TN 38117-2524 | 2011-11-27 |
| Find all providers with the same taxonomy | ||||
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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.