Information Collection

National Provider Identifier (NPI) Application and Update Form

IC 179125 under ICR 201512-0938-003 · OMB 0938-0931.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0938-0931 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form CMS-10114 National Provider Identifier (NPI) Application and Update Form	Form and Instruction
CMS-10114 NPI Application and Update Form CMS-10114 - NPI Application and Update Form.pdf	Form and Instruction

IC Title:

National Provider Identifier (NPI) Application and Update Form

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 45 CFR 142.408 45 CFR 162.406 45 CFR 162.408

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	CMS-10114	NPI Application and Update Form	CMS-10114 - NPI Application and Update Form.pdf		Yes	Yes	Fillable Fileable Signable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 541,800

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 75 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	541,800	541,800
Annual IC Time Burden (Hours)	180,600	180,600
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
No associated records found

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.