Individual provider Active NPI

Amanda Leigh Ferguson, LCSW

  • Clinical Social Worker
  • Knoxville, TN
National Provider Identifier
1205069127
Registry record updated Mar 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
5736 Issued in TN
Practice address
600 Arthur St
Knoxville, TN 37921-6405
Phone
(865) 523-8695
NPI assigned
Aug 26, 2009
Last updated
Mar 5, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X LSW0000010588 TN
Clinical Social Worker 1041C0700X 5736 TN Primary
Case Manager/Care Coordinator 171M00000X NU

Addresses

Primary practice location

600 Arthur St
Knoxville, TN 37921-6405

Mailing address

200 Tech Center Dr
Knoxville, TN 37912-2747
Phone (865) 637-9711

Other identifiers 1

IdentifierTypeStateIssuer
Q054694MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200305002945 TN Practitioner - Clinical Social Worker 8628405503 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LSW0000010588TNMDSocial Worker
5736TNMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Helen Ross McNabb Center CurrentSince Mar 7, 2021 Accepting new patients
Helen Ross McNabb Center CurrentSince Dec 22, 2019 Accepting new patients

Locations

200 Tech Center Dr
Knoxville, TN 37912
Phone (865) 329-9124

201 W Springdale Ave
Knoxville, TN 37917
Phone (865) 329-9173

600 Arthur St
Knoxville, TN 37921
Phone (865) 523-8695

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1251244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709596800000",
    "number": "1205069127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 TECH CENTER DR",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379122747",
            "telephone_number": "865-637-9711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 ARTHUR ST",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379216405",
            "telephone_number": "865-523-8695"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERGUSON",
        "first_name": "AMANDA",
        "middle_name": "LEIGH",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-08-26",
        "last_updated": "2024-03-05",
        "certification_date": "2024-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "TN",
            "license": "LSW0000010588",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TN",
            "license": "5736",
            "primary": true
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q054694",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Knoxville, TN

Sources for this page

Verify at the official NPI Registry.