23 Miss. Code. R. 200-4.9 - Group Providers

A. Business/ Entity enrolling as a group of providers so that all monies received shall report to the tax identification number of the business. The following criteria must apply:

1. The enrolling provider has a tax identification number.

2. The enrolling provider is not a sole proprietor.

3. The enrolling provider employs and notes an active individual servicing provider within their application.

B. Providers enrolling as a group must comply with the requirements set forth in Part 200, Chapter 4, Rule 4.8 for all providers, the requirements for their individual provider type requirements outlined in the assigned chapters of this code and the requirements listed below for group providers:

1. National Provider Identifier (NPI), verification from National Plan and Provider Enumeration System (NPPES).

2. Written confirmation from the IRS confirming your tax identification number and legal business name.

3. CLIA certificate and CLIA Certification form, if applicable.

4. At least one active individual provider is linked to the enrolling group.

C. This rule is applicable to the following provider types:

1. CRNA,

2. Nurse Practitioner,

3. Dentist,

4. Physician Assistant,

5. Dietician/ Nutritionist,

6. Occupational therapist,

7. Physical therapist,

8. Speech Therapist,

9. Optometrist,

10. Audiologist,

11. Nurse Midwife,

12. Pharmacist Disease Management,

13. Physician,

14. Osteopath (DO),

15. Chiropractor,

16. Podiatrist,

17. Psychologist, and

18. Licensed Certified Social Worker.

Notes

23 Miss. Code. R. 200-4.9

Miss. Code Ann. § 43-13-121