APEX Pharmacist Alliance • Educational & Professional Resource Centerapexpharmacistalliance.org
Independent Pharmacy Development

NPI & NPPES

Educational guidance for understanding the National Provider Identifier and the NPPES application system.

Educational information: Requirements can change and may vary by pharmacy type, ownership, service, payer, and jurisdiction. Confirm current requirements with official agencies and qualified professionals.

What an NPI is

CMS describes the NPI as a unique identifier used for covered healthcare providers in standard HIPAA administrative and financial transactions.

Individual vs organization

NPPES distinguishes individual (Type 1) and organization (Type 2) NPIs. Pharmacies should determine which identifiers are needed for their organization and services.

Maintain the record

After assignment, keep NPPES information current and coordinate updates with payer credentialing and other systems that depend on the NPI.