Richard William Cline Jr., D.O.
Individual provider Active NPI Family Medicine Physician · Fayetteville, TN
NPI 1043357916 · NPPES record last updated Apr 4, 2014
Key facts
- NPI
- 1043357916
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 2292 (TN)
- Practice address
- 108 Medical Center Blvd
Suite G-50
Fayetteville, TN 37334-2741 - Phone
- (931) 438-4111
- Fax
- (866) 521-2903
- NPI assigned
- Jan 31, 2007
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 2
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- Other, 1995
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Parkway Medical Group, PC
Practice addresses (Care Compare)
108 Medical Ctr Blvd
Fayetteville, TN 37334-2741
Phone (931) 438-4111
Hospital & facility affiliations
- Lincoln Medical Center
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal or shaving of skin growth | 1-10 |
| Skin biopsy | 1-10 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20111024000015 | TN | Practitioner - Family Practice |
5092988816 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0102050050 | VA | MD | Family Medicine Physician |
| 2292 | TN | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Parkway Medical Group, PC | Family Medicine | Current |
Accepting new patients |
| HH Health System - Lincoln Inc | Past | Accepting new patients |
Interoperability endpoints
- richardcline@pmgp-tn.direct.office.nextgen.com
- richardcline@parkwaymg.allscriptsdirect.net
- https://fhir.meditouchehr.com/api/fhir/r4/
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 0102050050 | VA | |
| Family Medicine Physician | 207Q00000X | 2292 | TN | Yes |
Addresses
Primary practice location
108 Medical Center Blvd
Suite G-50
Fayetteville, TN 37334-2741
Mailing address
108 Medical Center Blvd
Suite G-50
Fayetteville, TN 37334-2741
Phone (931) 438-4111
Other providers in Fayetteville, TN
- Chiropractic Health Center
- Christopher E Gafford Dba Gafford Family Medicine
- Kerri Lu Leva Cisney
- Laura Clark
- Robert Lewis Clark
- Rudy Theodore Cobb
- Colbert Family Densistry
- James E Colbert
- James Ernest Colbert III
- John C Compton
All providers in Fayetteville, TN · Family Medicine Physician in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 4, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.