ePrescribing Data Requirements - Providers (Prescriber)

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Provider Name

Recommended format: First Name Middle Initial Last Name Credential

NPI

This is the National Provider Identification Number.

You may check for numbers on the NPI Registry Search on the CMS site.

Note: NPI numbers are assigned to both individuals and groups/practices. This NPI must be the individual NPI.

License #

This is the State Medical License Number. If the doctor has 2 licenses, e.g. New York and New Jersey, enter them both with a comma separating them.

DEA #

The DEA-issued number allowing the provider to prescribe. Note: This number must be for that provider, they cannot use another provider's DEA.

Name

Must be as it appears on the state license and DEA certificate, and must include Last Name, First Name, MI, and Credential.

Supervising Provider

Some providers may prescribe, but legally must have a supervising provider.

Usually a provider with a non-MD credential (e.g. NP or PA)

Since all 50 states may have different legislation, it is the prescriber's responsibility to know if they require a supervising provider. If they do, the box must be checked.

Email Address

Must be an email address for the person, not a generic email for the pracice (e.g. info@).

Address for the Main Practice Location

• Address
• City
• State
• Zip: Zip+4 is required
• Work Phone
• Fax
• Cell Phone