National Provider Identifier (NPI) Application and Update Form and Supporting Regs in 45 CFR 142.408, 45 CFR 162.408, 45 CFR 162.406 (CMS-10114)

OMB 0938-0931

OMB 0938-0931

The National Provider Identifier (NPI) Application and Update Form is used by health care providers to apply for NPIs and furnish updates to the information they supplied on their initial applications. The form is also used to deactivate their NPIs if necessary. The form is available on paper or can be completed via a web-based process. An NPI is expected to last for the "life" of the health care provider (i.e., until the death of an individual or until the dissolution of an organization); therefore, a health care provider applies for an NPI only one time. A health care provider must furnish updates to the required information given in the application whenever changes occur to those data. Updates can be mailed or submitted electronically.

The latest form for National Provider Identifier (NPI) Application and Update Form and Supporting Regs in 45 CFR 142.408, 45 CFR 162.408, 45 CFR 162.406 (CMS-10114) expires 2021-06-30 and can be found here.

OMB Details

National Provider Identifier (NPI) Application

Federal Enterprise Architecture: Health - Health Care Services

Form CMS-10114NPI Application Fillable PrintableForm and instruction

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