Healthcare Provider Details

I. General information

NPI: 1811806433
Provider Name (Legal Business Name): RICHARD PENFIELD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/02/2026
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

198 HILLVIEW ST
DICKSON TN
37055-1285
US

IV. Provider business mailing address

5800 RIVER RD APT 110
NASHVILLE TN
37209-5628
US

V. Phone/Fax

Practice location:
  • Phone: 615-446-8159
  • Fax:
Mailing address:
  • Phone: 256-603-4705
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number17435
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: