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EAST TENNESSEE CHILDREN'S HOSPITAL PRIMARY CARE CENTER INC. NPI 1366648040


NPI Information

NPI: 1366648040
Provider Name: EAST TENNESSEE CHILDREN'S HOSPITAL PRIMARY CARE CENTER, INC.

Doing Business As: LAFOLLETTE PEDIATRICS

Classification: Pediatrics - 208000000X
Entity Type: Organization
Address:
2221 JACKSBORO PIKE STE C4
LA FOLLETTE, TN
ZIP 37766
Phone: (423) 566-3488
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EAST TENNESSEE CHILDREN'S HOSPITAL PRIMARY CARE CENTER, INC. is a pediatrics in La Follette, TN. The provider is 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. EAST TENNESSEE CHILDREN'S HOSPITAL PRIMARY CARE CENTER, INC. NPI is 1366648040. The provider is registered as an organization entity type.
The provider Is Doing Business As Lafollette Pediatrics.

The provider's business location address is:

2221 JACKSBORO PIKE STE C4
LA FOLLETTE, TN
ZIP 37766-007
Phone: (423) 566-3488
Fax: (866) 722-3453

The provider's authorized official is Caryn Hawthorne .
The authorized official title is Vice President Finance and has the following contact phone number (865) 541-8181.

The enumeration date for this NPI number is 6/21/2007 and was last updated on 6/8/2023.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QP2300XClinic/CenterPrimary CareNo
2363LP0200XNurse PractitionerPediatricsNo
3208000000XPediatricsYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1Q002836MEDICAIDTENNESSEE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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