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NPI Submission Form ? Individual Practitioner Provider Name: Provider Number: SECTION 1 ? BASIC INFORMATION A. Reason for Submittal of This Form (Check the appropriate box) 1. Initial Submission 3.
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NPI submission form individual is a form used to apply for or update an individual healthcare provider's National Provider Identifier (NPI) number.
Any individual healthcare provider who meets the criteria set by the Centers for Medicare & Medicaid Services (CMS) is required to file the NPI submission form individual. This includes physicians, dentists, nurses, and other healthcare professionals.
To fill out the NPI submission form individual, you need to provide personal and professional information, including your name, contact details, taxonomy code, and practice information. You can complete the form online or download a paper form from the NPI Enumerator website.
The purpose of the NPI submission form individual is to obtain or update an individual healthcare provider's NPI number. The NPI is a unique identification number assigned to healthcare providers and is used for billing, coordination of benefits, and other administrative purposes.
The NPI submission form individual requires you to report personal information such as your name, date of birth, and social security number. You also need to provide professional information like your taxonomy code, practice location, and contact details.
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Relevant keywords

Taxonomy NPI yy Submittal SSN wpc UPIN edi Suffix Credential Deactivation PRACTITIONERS applicable IRS Prefix Medicare Medicaid MD Practitioner Submission Dissolved Mailing Provider Postal IDENTIFYING

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