Information Collection

National Provider Identifier (NPI) Application and Update Form

IC 179125 under ICR 202604-0938-010 · OMB 0938-0931.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form CMS-10114 NPI Application and Update Form National Provider Identifier (NPI) Application and Update Form	Form and Instruction
CMS-10114 NPI Application and Update Form CMS-10114_NPI Application Update Form_clean 3.24.26.pdf	Form and Instruction

IC Title:

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 162.408 45 CFR 162.406

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				Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 767,803

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: 95 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	767,803	767,803
Annual IC Time Burden (Hours)	130,527	130,527
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.

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