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National Provider Identifier (NPI) Application
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
IC ID: 37925
OMB.report
HHS/CMS
OMB 0938-0931
ICR 201711-0938-003
IC 37925
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0938-0931 can be found here:
2024-11-05 - Reinstatement with change of a previously approved collection
2024-04-03 - No material or nonsubstantive change to a currently approved collection
Documents and Forms
Document Name
Document Type
Form CMS-10114
National Provider Identifier (NPI) Application
Form and Instruction
CMS-10114 NPI Application
CMS-10114 - Final NPI Form - 053018.docx
Form and Instruction
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
National Provider Identifier (NPI) Application
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 - Final NPI Form - 053018.docx
Yes
Yes
Fillable Printable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Health Care Services
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
313,175
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:
98 %
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
313,175
0
0
246,095
0
67,080
Annual IC Time Burden (Hours)
106,480
0
0
84,120
0
22,360
Annual IC Cost Burden (Dollars)
0
0
0
0
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.