23 Miss. Code. R. 203-1.1 - Provider Enrollment Requirements for Physicians, Osteopaths, Chiropractors, Podiatrists
Physician providers may participate in the Medicaid program upon compliance with provider enrollment requirements outlined in Part 200, Chapter 4, Rule 4.8 in addition to the specific provider type requirements listed below. Physicians, osteopaths, chiropractors and podiatrists must also meet the specific requirements as follow:
A. National Provider Identifier (NPI),
verification from National Plan and Provider Enumeration System
(NPPES)
B. Copy of licensure card
or letter from the appropriate board stating current certification and must be
from state of servicing location.
C. Verification of social security number
using a social security card, driver's license if it notes the social security
number, military ID or a notarized statement signed by the provider noting the
social security number. The name noted on verification must match the name
noted on the W-9.
D. CLIA
certificate and completed Certification form, if applicable
E. Copy of specialty certificate(s), if
applicable
Notes
State regulations are updated quarterly; we currently have two versions available. Below is a comparison between our most recent version and the prior quarterly release. More comparison features will be added as we have more versions to compare.
No prior version found.