CONTACT INFORMATION PAGE¶
Contact Person Information¶
If we have any questions regarding your NPI application or change request, we will reach out to the people listed as a Contact Person on the NPI application.
You are only required to enter one Contact Person, the Primary Contact Person, however, you may enter up to five. If you enter more than one Contact Person, one must be identified as being the Primary Contact Person.
The NPI notifications will be sent to all Contact Person Email Addresses.
Contact Person is same as Provider:¶
If you are creating a Type 1 NPI and the Contact person is the same as the Individual Provider, select the radio button that indicates Contact Person is same as Provider. Selecting the radio button will populate the Contact Person Name with the Individual Provider’s name entered on the Provider Profile page.
Contact Person is same as the Authorized Official:¶
If you are creating a Type 2 NPI and the contact person is the same as the Authorized Official, then please select the radio button that indicates Contact Person is same as the Authorized Official. Selecting the radio button will populate the Contact Person name with the Authorized Official’s name entered on the Provider Profile page.
Contact Person is same as Myself:¶
If the contact person is yourself, then please select the radio button that indicates Contact Person is same as Myself. Selecting this radio button will populate the Contact Person information with your information from your I&A account.
Contact Person Name and Contact information:¶
Provide the Contact Person name details in the specified order, Prefix, First, Middle, Last, Suffix, Credential(s), Title/ Position and Contact information like Telephone number, extension, and Email. Prefix: Provide Prefix if applicable by selecting from the dropdown list as shown below.
- Dr.
- Miss
- Mr.
- Mrs.
- Ms.
- Prof.
- First:
- Provide the Contact Person’s First name, this is a mandatory field.
- Middle:
- Provide the Contact Person’s Middle name, if applicable.
- Last:
- Provide the Contact Person’s Last name, this is a mandatory field.
Suffix: Provide Suffix if applicable by selecting from the dropdown list as shown below.
- I
- II
- III
- IV
- V
- VI
- VII
- VIII
- IX
- X
- Jr.
- Sr.
Credential(s): (M.D, D.O, etc.) Provide the Contact Person’s Credential(s) if applicable. Title/ Position: Provide Title or Position, if applicable. Telephone Number: Provide the Telephone Number, this is a required field. Extension: Provide the Telephone Number Extension, if applicable. Contact Person Email: Provide the Contact Person’s email, if available.