EAST TENNESSEE CHILDREN'S HOSPITAL PRIMARY CARE CENTER, INC.
NPI 1790980977
Pediatrics in Seymour, TN

NPI Status: Active since June 18, 2007

Contact Information

11616 CHAPMAN HWY
SEYMOUR, TN
ZIP 37865
Phone: (865) 579-3720
Fax: (866) 406-8173

Get Directions Write a Review

  • Organization
  • Pediatrics
  • CLIA Number: 44D0876042
  • CLIA Cert. Type: Physician Office
  • CLIA Exp. Date: 08-11-2027

About EAST TENNESSEE CHILDREN'S HOSPITAL PRIMARY CARE CENTER, INC.

This page provides the complete NPI Profile along with additional information for East Tennessee Children's Hospital Primary Care Center, Inc., a pediatrician established in Seymour, Tennessee operating as a Pediatrics. The healthcare provider is registered in the NPI registry with number 1790980977 assigned on June 2007. The practitioner's primary taxonomy code is 208000000X. The provider is registered as an organization and their NPI record was last updated January 2026. The provider's . The authorized official of this NPI record is Andrew Rosendahl (Chief Financial Officer)

NPI
1790980977
Provider Legal Name
EAST TENNESSEE CHILDREN'S HOSPITAL PRIMARY CARE CENTER, INC.
Other Organization Name
Other Name Type
(6)
Entity Type
Organization
Location Address
11616 CHAPMAN HWY SEYMOUR, TN 37865
Location Phone
(865) 579-3720
Location Fax
(866) 406-8173
Mailing Address
PO BOX 15004 KNOXVILLE, TN 37901
Mailing Phone
(865) 541-8895
Mailing Fax
(866) 406-8173
Is Sole Proprietor?
No
Is Organization Subpart?
Yes
Enumeration Date
06-18-2007
Last Update Date
01-14-2026
Code Navigator

A pediatrician like East Tennessee Children's Hospital Primary Care Center, Inc. is a physician who has completed a pediatric residency and is board-certified or board-eligible in a pediatric specialty. Pediatric care providers are trained to care for newborns, infants, children and adolescents. A pediatrician could perform physical exams, manage vaccinations, monitor development milestones, diagnose illnesses, infections, injuries or other health problems, etc.

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Pediatrics

Taxonomy Code
208000000X
Type
Allopathic & Osteopathic Physicians
Taxonomy Description
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.

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No. Taxonomy Code Type Classification /
Specialization
License No. (State)
1261QP2300XAmbulatory Health Care Facilities

Clinic/Center
Primary Care

 
2363LF0000XPhysician Assistants & Advanced Practice Nursing Providers

Nurse Practitioner
Family

 

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

ANDREW ROSENDAHL

Authorized Official Title
CHIEF FINANCIAL OFFICER
Authorized Official Phone
(865) 541-8154

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
Q002824MEDICAID (05)TN 

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
44D0876042
Facility Type
Physician Office
Certificate Effective Date
August 12, 2025
Certificate Expiration Date
August 11, 2027
Laboratory Director
DR. STEPHANIE L. GORMAN
Certificate Type
Certificate of Compliance
Certificate Type Description
This CLIA certificate is issued to East Tennessee Children's Hospital Primary Care Center, Inc. after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements. This type of certificate is issued to laboratories that perform nonwaived (moderate and/or high complexity) testing.

Reviews for EAST TENNESSEE CHILDREN'S HOSPITAL PRIMARY CARE CENTER, INC.

There are currently no reviews for this provider. Be the first person to share your experience with this provider by filling out our review form. Your insights are appreciated and will help others make informed decisions.

NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1790980977, we treat the final digit (7) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 73. The final step is to find the difference between that total and the next multiple of ten (80 - 73 = 7).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
7
Unchanged
Pos 3
9
Doubled → 18 → 1 + 8
Pos 4
0
Unchanged
Pos 5
9
Doubled → 18 → 1 + 8
Pos 6
8
Unchanged
Pos 7
0
Doubled → 0
Pos 8
9
Unchanged
Pos 9
7
Doubled → 14 → 1 + 4
Check
7
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 9 → 18 → 9 9 → 18 → 9 0 → 0 7 → 14 → 5

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 7 + 1 + 8 + 0 + 1 + 8 + 8 + 0 + 9 + 1 + 4 + 24 = 73

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 73 is 80. The difference is the calculated check digit.

80 - 73 = 7
This NPI is valid
The calculated check digit is 7, which matches the last digit of 1790980977.

Other Providers at the Same Location


The following 5 providers are registered at the same or a nearby location.

Pediatrics
11616 CHAPMAN HWY
SEYMOUR, TN 37865
Pediatrics
11616 CHAPMAN HWY
SEYMOUR, TN 37865
Pediatrics
11616 CHAPMAN HWY
SEYMOUR, TN 37865
Nurse Practitioner (Family)
11616 CHAPMAN HWY
SEYMOUR, TN 37865
Pediatrics
11616 CHAPMAN HWY
SEYMOUR, TN 37865

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1790980977, enumerated as an "organization" on June 18, 2007.

The provider is located at 11616 CHAPMAN HWY SEYMOUR, TN 37865 and the phone number is (865) 579-3720.

Pediatrics with taxonomy code 208000000X.

The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.