NPIMap

Individual provider Active NPI

Amanda B Squires, MD

  • Diagnostic Radiology Physician
  • Knoxville, TN
National Provider Identifier
1417984402
Registry record updated Jul 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
MD40733 Issued in TN
Practice address
2001 Laurel Ave # N304
Knoxville, TN 37916-1810
Phone
(865) 595-4100
NPI assigned
Jun 27, 2006
Last updated
Jul 27, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X MD40733 TN Primary

Addresses

Primary practice location

2001 Laurel Ave # N304
Knoxville, TN 37916-1810

Mailing address

2001 Laurel Ave # N304
Knoxville, TN 37916-1810
Phone (865) 595-4100

Other identifiers 1

IdentifierTypeStateIssuer
620476822OtherTAX ID

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060804000286 TN Practitioner - Diagnostic RadiologyPractitioner - Radiation Oncology 2466455761 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Tulane University School of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vista Radiology, PCGroup PAC ID 9234041559, 64 clinicians

Practice addresses (Care Compare)

2001 Laurel Ave
Suite N304
Knoxville, TN 37916-1810
Phone (865) 546-9484

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
79.28 of 100Reported as group
Quality
75.62
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD40733TNMDDiagnostic Radiology Physician
40733TNMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
North Mississippi Radiology Services LLC Diagnostic Radiology CurrentSince May 1, 2022 Accepting new patients
El Portal Radiation Oncology Center CurrentSince Feb 24, 2020 Accepting new patients
Northside Radiology Associates LLC Diagnostic Radiology PastSince Aug 1, 1996 Accepting new patients
Vanderbilt University Medical Center Diagnostic Radiology Past Accepting new patients
Downtown Radiology Inc Past Accepting new patients

Locations

Dept LA 23779
Pasadena, CA 91185

Organizations & group practices 6

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1151366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785110400000",
    "number": "1417984402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 LAUREL AVE # N304",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379161810",
            "telephone_number": "865-595-4100",
            "fax_number": "865-525-6811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 LAUREL AVE # N304",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379161810",
            "telephone_number": "865-595-4100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SQUIRES",
        "first_name": "AMANDA",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-27",
        "last_updated": "2026-07-27",
        "certification_date": "2026-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "TN",
            "license": "MD40733",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "620476822",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Knoxville, TN

Sources for this page

Verify at the official NPI Registry.