INTRODUCTION PAGE FOR INDIVIDUAL PROVIDER OR ORGANIZATION NPI APPLICATIONS

The Introduction page provides a list of the information required to complete the NPI Application.

INDIVIDUAL PROVIDERS:

Provider Name
SSN
Provider Date of Birth
Country of Birth
State of Birth (if Country of Birth is U.S.)
Provider Gender
Mailing Address
At least one Practice Location Address and Phone Number
At least one Taxonomy (Provider Type) *
State License Information **
At least one Contact Person Name
At least one Contact Person Phone Number and Email

* Provider Taxonomy codes can be obtained from here
** (required for certain taxonomies only)

Organizations:

Organization Name
Employer Identification Number (EIN) *
Name of Authorized Official for the Organization
Title/Position of Authorized Official for the Organization
Phone Number of Authorized Official for the Organization
Organization Mailing Address
At least one Practice Location Address and Phone Number
At least one Taxonomy (Provider Type) **
At least one Contact Person Name
At least one Contact Person Phone Number and E-mail

* Do not report an SSN or IRS ITIN in the EIN field (Org only)
** Provider Taxonomy codes can be obtained from here

Introduction Page Navigation:

The following are the navigation buttons provided at the bottom of the Introduction page.

Cancel Button:

Upon selecting the 'Cancel' button you will be navigated to the Main Page.

Next Button:

Upon selecting the 'Next' button you will be navigated to the Profile page.