Entity Registration (Renewal & Update)

National Practitioner Data Bank for Adverse Information on Physicians and Other Health Care Practitioners: 45 CFR Part 60 Regulations and Forms

OMB: 0906-0081

IC ID: 206504

Documents and Forms
Information Collection (IC) Details

View Information Collection (IC)

Entity Registration (Renewal & Update)
 
No Modified
 
Required to Obtain or Retain Benefits
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 25 Entity Registration (Renewal & Update).pdf Entity Registration (Renewal Update).pdf Yes Yes Fillable Fileable

Health Consumer Health and Safety

System of Record Notice 09-15-0054  88 FR 17854

12,990 500
   
State, Local, and Tribal Governments
 
   50 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 12,990 0 -255 0 0 13,245
Annual IC Time Burden (Hours) 3,248 0 -63 0 0 3,311
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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