Amanda Surdock, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

3506 Issued in TN

Practice address

162D Market Place Blvd
Knoxville, TN 37922-2337

Phone

(865) 212-6600

Fax

(865) 313-2149

NPI assigned

Oct 8, 2014

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Tennessee Valley TMS, LLC

  • Behavioral Neurology & Neuropsychiatry Physician
  • Knoxville, TN
  • NPI 1649889130
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1412726400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582156800000",
    "number": "1093118754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12187 INGLECREST LN",
            "city": "FARRAGUT",
            "state": "TN",
            "postal_code": "379345321",
            "telephone_number": "901-338-1219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "162D MARKET PLACE BLVD",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379222337",
            "telephone_number": "865-212-6600",
            "fax_number": "865-313-2149"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SURDOCK",
        "first_name": "AMANDA",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-10-08",
        "last_updated": "2020-02-20",
        "certification_date": "2020-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MS",
            "license": "54-947",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "TN",
            "license": "3506",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sunshine Chiropractic Clinic
• Sunshine Services
• Sunsphere Psychiatry PLLC
• George Peter Suranyi, DMD
• Casey Laurel Surber, M.A., CCC-SLP
• Urath Suresh, MD
• Surgery Center of Knox County, PC
• Surgery on Sunday - East Tennessee
• Surgical Oncology Associates
• Samantha Surprenant

• Clinical Psychologist in Knoxville, TN
• Providers in Knoxville, TN by specialty
• Clinical Psychologist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.