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How to use or fill out OMB No. 0938-0931 NATIONAL PROVIDER IDENTIFIER (NPI) Application with our platform
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Click ‘Get Form’ to open the NPI application in the editor.
In Section 1, select the reason for submitting the form: Initial Application, Change of Information, or Deactivation. Ensure you check the appropriate box and provide your NPI number if applicable.
Proceed to Section 2 to enter identifying information. For individuals, fill in your full legal name, date of birth, gender, and Social Security Number (if applicable). Organizations should provide their legal business name and Employer Identification Number (EIN).
In Section 3, complete your mailing address and primary practice location details. Make sure all addresses are accurate to avoid processing delays.
Review Section 4 for the certification statement. Sign and date it to confirm that all information is true and complete.
Finally, provide contact information in Section 5 for any follow-up questions regarding your application.
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