=====================================================
General NPI Number Information
=====================================================
NPI Number | 1871420091
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | EAST TENNESSEE CHILDREN'S HOSPITAL ASSOCIATION INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/04/2026
-----------------------------------------------------
Last Update Date | 05/04/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 611 22ND ST
-----------------------------------------------------
City | KNOXVILLE
-----------------------------------------------------
State | TN
-----------------------------------------------------
Zip | 37916-2211
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 865-637-1346
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 15004
-----------------------------------------------------
City | KNOXVILLE
-----------------------------------------------------
State | TN
-----------------------------------------------------
Zip | 37901-5004
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 865-541-8895
-----------------------------------------------------
Fax | 865-633-4808
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CFO
-----------------------------------------------------
Name | ANDREW ROSENDAHL
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 612-237-4353
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 208000000X
-----------------------------------------------------
Taxonomy Name | Pediatrics Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------