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

⚠️ Notice: This information collection may be referencing outdated material.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

Documents and Forms

Document Name Document Type
Form CMS-10114 National Provider Identifier (NPI) Application and Update Form and Supporting Regs in 45 CFR 142.408, 45 CFR 162.408, 45 CFR 162.406 Form and Instruction
CMS-10114 NPI Application CMS-10114-draft (02202008).pdf Form and Instruction
CMS revised Responses Revised CMS 10114 ~ Responses to Public Comments 05222008-1.doc Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	National Provider Identifier (NPI) Application and Update Form and Supporting Regs in 45 CFR 142.408, 45 CFR 162.408, 45 CFR 162.406	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:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	CMS-10114	NPI Application	CMS-10114-draft (02202008).pdf		Yes	Yes	Fillable Fileable
Form and Instruction	CMS revised	Responses	Revised CMS 10114 ~ Responses to Public Comments 05222008-1.doc		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 35,880	Number of Respondents for Small Entity: 0

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

Percentage of Respondents Reporting Electronically: 75 %

	Approved	Previously Approved
Annual Number of Responses for this IC	35,880	35,880
Annual IC Time Burden (Hours)	11,960	11,960
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

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.