National Provider Identifier
| Agency Section Number | Section IV – General Administration |
| Agency/Division | NC Department of Health and Human Services (NCDHHS) |
| Policy Effective Date | 2006-10-03T10:45:00-04:00 |
| Policy File | national_provider_identifier.pdf |
Policy Purpose
This policy establishes the plan and responsibilities for enumerating individual health care
providers within the North Carolina Department of Health and Human Services (NC DHHS)
workforce as required by the Health Insurance Portability and Accountability Act (HIPAA)
(Public Law 104-191) Standard Unique Health Identifier for Health Care Providers, 69 Fed.
Reg. 3434-3469 (January 23, 2004) (to be codified at 45 CFR Part 162). The Standard
Unique Health Identifier for Health Care Providers, also known as the National Provider
Identifier (NPI), Final Rule establishes the NPI as the standard, unique, provider identifier to
be used to identify the health care provider on HIPAA standard transactions. These
transactions include claims, eligibility queries and responses, claims status queries and
responses, referrals, and remittance advices. The NPI replaces all legacy numbers for
providers such as Medicare/Medicaid identifiers, unique physician identification numbers,
private health plan issued numbers, etc.
The purpose of the NPI is to improve the effectiveness and efficiency of the health care
industry by enabling more efficient electronic transmission of certain health information and
reducing the number of identifiers each health care provider is required to maintain.
The purpose of the NPI is to improve the effectiveness and efficiency of the health care industry by enabling more efficient electronic transmission of certain health information and reducing the number of identifiers each health care provider is required to maintain.