National Provider Identifier (NPI)

NPI Submission Form - This form allows Physicians/Clinicians to enter their NPI information and route this information to the appropriate resource at the appropriate Ministry Organization (s). In addition, an email will be sent to the address that the Submitter includes on the submission form.

All * fields are required.
Submitter Name: *
Physician/Clinician Name : *
Office Address: *
City: *
State: *
Zipcode (+four if known): *
Physician Specialty: *
Office Phone Number (xxx.xxx.xxxx): Optional
UPIN Number: *
NPI Number: *
Primary Taxonomy Code: Optional
Email Confirmation: Optional
(Enter email address for confirmation email)
Ministry Organization(s) : Please select your Ministry Organization(s) below: *
CALIFORNIA
Saint Agnes Medical Center, Fresno, California
IDAHO
Saint Alphonsus Regional Medical Center, Boise, Idaho
St. Benedict's Family Medical Center, Jerome, Idaho
INDIANA
Saint Joseph Regional Medical Center, Mishawaka, Indiana
Saint Joseph Regional Medical Center, South Bend, Indiana
Saint Joseph Regional Medical Center, Plymouth, Indiana
IOWA
Mercy Medical Center - Clinton, Iowa
Mercy Medical Center - Dubuque, Iowa
Mercy Medical Center - Dyersville, Iowa
Mercy Medical Center - New Hampton, Iowa
Mercy Medical Center - North Iowa, Mason City, Iowa
Mercy Medical Center - Sioux City, Iowa
MARYLAND
Holy Cross Hospital, Silver Spring, Maryland
MICHIGAN
Battle Creek Health System
Grand Rapids Pine Rest, Grand Rapids, Michigan
Mercy General Health Partners, Muskegon, Michigan
Mercy Hospital - Cadillac, Michigan
Mercy Hospital - Grayling, Michigan
Mercy Hosptial - Port Huron, Michigan
Saint Joseph Mercy Health System, Ann Arbor, Saline, Livingston, Michigan
Saint Mary's Health Care, Grand Rapids, Michigan
St. Joseph Mercy Oakland, Pontiac, Michigan
St. Joseph's Healthcare, Clinton Township, Michigan
St. Mary Mercy Hospital, Livonia, Michigan
Trinity Home Health Services, Novi, Michigan
OHIO
Mount Carmel Health System - Mount Carmel East, Columbus, Ohio
Mount Carmel Health System - Mount Carmel St. Ann's, Westerville, Ohio
Mount Carmel Health System - Mount Carmel West, Colmbus, Ohio
Click the 'Submit' button to send your request