ADDRESS PAGE

The address information will be used to contact the provider if there are any questions about NPI application. You will be required to enter a Business Mailing address, and a Primary Practice Location. You may enter multiple additional Practice Locations.

Business Mailing Address:

You must provide an address where we can contact you directly to resolve any issues that may arise during our review of your application. (Required) This information will assist us in contacting you with any questions we may have regarding your application for an NPI or with other information regarding NPI. The address can be any mailing address where you receive mail, including Post Office Boxes and Commerical Mail Receiving Agencies (CMRAs).

Add a Business Mailing Address Button:

Upon selecting the ‘Add a Business Mailing Address’ button, you will be navigated to the Business Mailing Address page.

The button will be available if no Business Mailing Address has been associated with the NPI. The button will no longer appear once a Business Mailing Address has been associated with the NPI.

Edit Business Mailing Address Button:

Upon selecting the ‘Edit Business Mailing Address’ button you will be navigated to Business Mailing Address window where you can edit the Business Mailing Address.

This button will not appear until the Business Mailing Address has been created/saved.

Practice Location Address:

You must provide a Physical address, this cannot be a PO Box or CMRA (Commercial Mail Receiving Agency). This is the location where the actual services are rendered. Users can enter multiple addresses, but only one primary practice location is required to be specified.

Add a Practice Location Button:

Upon selecting the ‘Add a Business Practice Location’ Button, you will be navigated to Practice Location Address window where you can enter the Practice Location Address information.

The button will be available if no Practice Location Address has been associated with the NPI. The button will no longer appear once a Practice Location Address has been associated with the NPI.

Add another Practice Location Button:

Upon selecting the ‘Add another Practice Location’ button you will be navigated to Practice Location Address window where you can enter a new Practice Location to associate with the NPI.

Address Page Navigation:

Previous Button:

Upon selecting the ‘Previous’ button you will be navigated to the Profile page.

Next Button:

Upon selecting the Next Button you will be navigated to Other Identifiers Page.

Save & Return to Main Page Button:

Upon selecting the Save & Return to Main Page Button the entries made are saved and you will be navigated to the Main page.

Business Mailing Address Window:

Business Mailing Address Page provides options to select type of address, and option to indicate if the address is same of home address.

Select Type of Address:

The following Radio Buttons are provided to select the type of address, this is a Required Field:

  • US Domestic
  • Military
  • Outside US/ Foreign

This is My Home Address:

A Check box is provided to specify if the address provided is same as the provider’s home address.

Business Mailing Address - US Domestic

Upon selecting the type of address radio button of ‘US Domestic’, the Business Mailing Address changes to accommodate the required address details and contact information.

The Address Line 1, Address Line 2, and City fields allow the following special characters: ampersand, apostrophe, colon, comma, forward slash, hyphen, left and right parentheses, period, pound sign, quotation mark, and semi-colon. In addition, the Address Line 1 and Address Line 2 fields allow the “at” sign. A field cannot contain all special characters.

Domestic Business Mailing Address Line 1:

Enter Line 1 of the mailing address here by typing in the Street Number and Name or Post Office Box Number in the given space. This is a mandatory field.

Domestic Business Mailing Address Line 2:

Enter Line 2 of the mailing address in the given space. This is a not a mandatory field.

Domestic Business Mailing Address City:

Enter the name of the City by typing in the given space. This is a mandatory field.

Domestic Business Mailing Address State:

Select the State from drop down list. This is a mandatory field.

Domestic Business Mailing Address Zip Code:

Enter the Zip Code of the Mailing Address here. This is a mandatory field.

Domestic Business Mailing Address +4 Zip Code:

Enter the +4 Zip Code of the Mailing Address here. This is a not a mandatory field.

Domestic Business Mailing Address Telephone Number:

Enter the Telephone Number. This is a required field.

Domestic Business Mailing Address Extension:

Enter the Telephone Number Extension if applicable. This is not a required field.

Domestic Business Mailing Address Fax Number:

Enter the Fax number if available. This is not a required field.

Business Mailing Address - Military

Upon selecting the type of address radio button of ‘Military’, the Business Mailing Address changes to accommodate the required address details and contact information.

Mailing address Line 1, Mailing Address Line 2, and City fields allow the following special characters: ampersand, apostrophe, colon, comma, forward slash, hyphen, left and right parentheses, period, pound sign, quotation mark, and semi-colon. In addition, the Address Line 1 and Address Line 2 fields allow the “at” sign. A field cannot contain all special characters.

Military Business Mailing Address Line 1:

Enter Line 1 of the mailing address here by typing in information such as the PSC or Ship Name in the given space. This is a mandatory field.

Military Business Mailing Address Line 2:

Enter Line 2 of the mailing address here by typing in information such as the CVN, Box Number, or Unit Number in the given space. This is a not a mandatory field.

Military Business Mailing Address City:

Select the City from the drop down list, this is a mandatory field. The list of choices given are:

  • APO
  • FPO
  • DPO
Military Business Mailing Address State:

Select the State from the drop down list. This is a mandatory field. The list of choices given are:

  • AA
  • AE
  • AP
Military Business Mailing Address Zip Code:

Enter the Zip Code here. This is a required field.

Military Business Mailing Address +4 Zip Code:

Enter the +4 Zip Code. This is not a mandatory field.

Military Business Mailing Address Telephone Number:

Enter the Telephone Number here. This is a required field.

Military Business Mailing Address Telephone Number Extension:

Enter Telephone Number Extension if applicable. This is not a mandatory field.

Military Business Mailing Address Fax Number:

Enter Fax number if available. This is not a mandatory field.

Business Mailing Address - Outside US/ Foreign

Upon selecting the type of address radio button of ‘Outside US/ Foreign’, the Business Mailing Address changes to accommodate the required address details and contact information.

Address Line 1, Address Line 2, and City fields allow the following special characters: ampersand, apostrophe, colon, comma, forward slash, hyphen, left and right parentheses, period, pound sign, quotation mark, and semi-colon. In addition, the Address Line 1 and Address Line 2 fields allow the “at” sign. A field cannot contain all special characters.

Foreign Business Mailing Address Line 1:

Enter Line 1 of the mailing address here by typing in the Street Number and Name in the given space. This is a mandatory field.

Foreign Business Mailing Address Line 2:

Enter Line 2 of the mailing address here by typing in the Apartment/Suite Number or any other additional address information in the given space. This is a not a mandatory field.

Foreign Business Mailing Address City:

Enter the Name of the City in the given space. This is a mandatory field.

Foreign Business Mailing Address Province or Territory:

Enter Foreign Province name or Territory name in the given space. This is a mandatory field.

Foreign Business Mailing Address Postal Code:

Enter the Foreign Postal code in the given space. This is a required field.

Foreign Business Mailing Address Country:

Select the name of the Country form the drop down list. This is a mandatory field.

Foreign Business Mailing Address Telephone Number:

Enter the Telephone Number associated with the mailing address. This is a required field.

Foreign Business Mailing Address Extension:

Enter the Telephone Number Extension if applicable. This is not a mandatory field.

Foreign Business Mailing Address Fax Number:

Enter Fax number if available. This is not a mandatory field.

Business Mailing Address Window Navigation Buttons:

Business Mailing Address Clear Button:

Upon selecting the ‘Clear’ button the information populated in the provided spaces will be cleared.

Business Mailing Address Save Button:

Upon selecting the ‘Save’ button information populated in the provided spaces will be saved.

Practice Location Address Window:

Practice Location Address Page identifies the address(es) where service is rendered. You may associate multiple Practice Location with an NPI. However, at least one Practice Location must be associated with an NPI and one Practice Location must be identified as the Primary Practice Location.

Select Type of Practice Location Address:

The following Check box options are provided to select the Practice Location address type. The address type will be defaulted to US Domestic.

  • US Domestic
  • Military
  • Outside US/Foreign

Practice Location is the Same as Mailing Address:

A Check box is provided to specify if the Practice Location address is same as the Business Mailing address. When selected the address will be prepopulated with the Business Mailing Address information.

This is My Home Address:

A Check box is provided to specify if the Practice Location address being provided is same as the provider’s home address.

Primary Practice Location Address:

A Check box is provided to specify if the address being provided is the Primary Practice Location address

Practice Location - US Domestic

Upon selecting the type of address radio button of ‘US Domestic’, the Practice Location page changes to accommodate the required address details and contact information.

The Address Line 1, Address Line 2, and City fields allow the following special characters: ampersand, apostrophe, colon, comma, forward slash, hyphen, left and right parentheses, period, pound sign, quotation mark, and semi-colon. In addition, the Address Line 1 and Address Line 2 fields allow the “at” sign. A field cannot contain all special characters.

Domestic Practice Location Address Line 1:

Provide Line 1 of the Practice Location Address by typing in the Street Number and Name in the given space. This is a mandatory field.

Domestic Practice Location Address Line 2:

Provide Line 2 of the Practice Location address in the given space. This is a not a mandatory field.

Domestic Practice Location City:

Provide the name of the City in the given space. This is a mandatory field.

Domestic Practice Location State:

Select the State from the drop down list. This is a mandatory field.

Domestic Practice Location Zip Code:

Provide the Zip Code. This is a required field.

Domestic Practice Location +4 Zip:

Provide the +4 Zip Code of the Practice Location. This is a not a mandatory field.

Domestic Practice Location Telephone Number:

Provide the Telephone Number associated with the Practice Location. This is a required field.

Domestic Practice Location Extension:

Provide Telephone Number Extension if applicable. This is not a required field.

Domestic Practice Location Fax Number:

Provide Fax number if applicable. This is not a required field.

Practice Location Address - Military

Upon selecting the type of address radio button of ‘Military’, the Practice Location Address changes to accommodate the required address details and contact information.

The Practice Location Address Line 1, Address Line 2, and City fields allow the following special characters: ampersand, apostrophe, colon, comma, forward slash, hyphen, left and right parentheses, period, pound sign, quotation mark, and semi-colon. In addition, the Address Line 1 and Address Line 2 fields allow the “at” sign. A field cannot contain all special characters.

Military Practice Location Address Line 1:

Provide the mailing address here by typing in information such as the PSC or Ship Name in the given space. This is a mandatory field.

Military Practice Location Address Line 2:

Provide Line 2 of the Practice Location address by typing in information such as the CVN, Box Number, or Unit Number in the given space. This is a not a mandatory field.

Military Practice Location City:

Select the City from the drop down list. The list of choices given are:

  • APO
  • FPO
  • DPO
Military Practice Location State:

Select the State from drop down list. The list of choices given are:

  • AA
  • AE
  • AP
Military Practice Location Zip Code:

Provide the Zip Code of the Practice Location. This is a required field.

Military Practice Location +4 Zip Code:

Provide the +4 Zip Code. This is not a mandatory field.

Military Practice Location Telephone Number:

Provide the Telephone Number associated with the Practice Location. This is a required field.

Military Practice Location Extension:

Provide the Telephone Number Extension if applicable. This is not a mandatory field.

Military Practice Location Fax Number:

Provide Fax number if applicable. This is not a mandatory field.

Practice Location Address - Outside US/ Foreign

Upon selecting the type of address radio button of ‘Outside US/ Foreign’, the Mailing Address changes to accommodate the required address details and contact information.

The Practice Location Address Line 1, Address Line 2, and City fields allow the following special characters: ampersand, apostrophe, colon, comma, forward slash, hyphen, left and right parentheses, period, pound sign, quotation mark, and semi-colon. In addition, the Address Line 1 and Address Line 2 fields allow the “at” sign. A field cannot contain all special characters.

Foreign Practice Location Address Line 1:

Provide Line 1 of the Practice Location by typing in the Street Number and Name in the given space. This is a mandatory field.

Foreign Practice Location Address Line 2:

Provide Line 2 of the Practice Location Address by typing in information such as the Apartment/Suite Number or any other additional address information in the given space. This is a not a mandatory field.

Foreign Practice Location City:

Provide the Name of the Practice Location Address City. This is a mandatory field.

Foreign Practice Location Foreign Province or Territory:

Provide Foreign Province name or Territory name in the given space. This is a mandatory field.

Foreign Practice Location Foreign Postal Code:

Provide the Foreign Postal code in the given space. This is a required field.

Foreign Practice Location Country:

Select the name of the Country form the drop down list. This is a mandatory field.

Foreign Practice Location Telephone Number:

Provide the Telephone Number associated with the Practice Location. This is a required field.

Foreign Practice Location Extension:

Provide the Telephone Number Extension if applicable. This is not a mandatory field.

Foreign Practice Location Fax Number:

Provide Fax number if available. This is not a mandatory field.

Languages Spoken:

Providing the Languages Spoken at a Practice Location is optional. You may select one or more languages.

Office hours:

Providing the Office Hours of a Practice Location is optional. Office hours and timing details are enabled with flexible options as shown below:

  • Seven sliding buttons with options to select Open or Closed are provided for each day of the week starting from Monday to Sunday.
  • Under each day there are two drop down boxes to indicate the opening and closing times.
  • A Check Box option is provided to select or deselect ‘apply to all’, upon selection of the check box, the times selected in the two drop down boxes will be applicable to all the days that are selected as Open under the days starting from Monday to Sunday.

Accessibility:

Providing the Practice Location’s accessibility to individuals with mobility disabilities is optional.

  • Identify if the Practice Location Office is accessible to individuals with mobility disabilities by selecting the appropriate Radio Button option to ‘Yes’ or ‘No’
  • Identify if the Practice Location Office exam rooms are accessible to individual with mobility disabilities by selecting the appropriate Radio Button ‘Yes’ or ‘No’.
  • Identify if the Practice Location Office medical equipment is accessible to individual with mobility disabilities by selecting the appropriate Radio Button ‘Yes’ or ‘No’.

Practice Location Address Window Navigation Buttons:

Practice Location Address Cancel Button:

Upon selecting the ‘Cancel’ button the information populated in the provided spaces will be canceled.

Practice Location Address Save Button:

Upon selecting the ‘Save’ button information populated in the provided spaces will be saved.