You may see an NPI on a claim form, a referral, a prescription or a provider directory. Billing teams, health plans, pharmacies and clinics use it to identify exactly which provider or organization they are dealing with. You can look one up yourself, too: the official NPI Registry is free and public.
What Does NPI Stand For?
NPI stands for National Provider Identifier.
“National” means the number is used across the whole United States, not only in one state or by one insurer. “Provider” means anyone who delivers healthcare, whether a person or an organization. “Identifier” means its job is to point to one specific provider and no one else.
A Social Security number identifies a person for tax and benefit purposes. An NPI does something similar for healthcare providers in healthcare transactions.
What Is an NPI Number?
An NPI is a unique identification number for healthcare providers. It was created under the Administrative Simplification rules of HIPAA, the Health Insurance Portability and Accountability Act of 1996. The NPI Final Rule, published in 2004, made it the standard provider identifier.
Before NPIs existed, one doctor could have a different ID number with each health plan, including Medicare. That made billing and record-matching slow and error-prone. The NPI replaced those separate numbers with a single identifier everyone uses.
Today, healthcare providers covered by HIPAA must use their NPI in standard electronic transactions, such as claims, eligibility checks, claim status inquiries and referrals. Health plans and healthcare clearinghouses must also use NPIs to identify providers in those transactions.
What Does an NPI Number Look Like?
An NPI is a 10-digit number made up only of numbers. It has no letters, dashes or spaces.
1234567890
CMS calls the NPI “intelligence-free.” The digits carry no hidden information: you cannot tell a provider's state, specialty or provider type by reading the number. The NPI simply points to a record, and the record holds the details.
The last digit is a check digit, calculated from the first nine with a standard formula (the Luhn algorithm). Software uses it to catch typing mistakes. A number that passes the check is correctly formatted, but that does not mean it belongs to a real, active provider. Only a registry lookup can confirm that.
Who Gets an NPI Number?
Any healthcare provider can apply for an NPI, and providers who are HIPAA-covered entities must have one. A provider is covered if they send health information electronically in a standard transaction, such as billing a health plan, even when a billing company sends it for them.
Individual providers who commonly have NPIs
- Physicians
- Nurses and nurse practitioners
- Dentists
- Pharmacists
- Chiropractors
- Physical therapists and other therapists
CMS says medical students, interns and residents are also eligible and must apply.
Organizations that commonly have NPIs
- Hospitals
- Clinics and group practices
- Laboratories
- Pharmacies
- Nursing homes
- Home health agencies
- Ambulance companies
- Durable medical equipment suppliers
Who does not get one
Not everyone who works in healthcare has an NPI. Staff who do not provide care, such as receptionists or office managers, are generally not eligible. Some businesses are excluded because they are not healthcare providers; CMS gives billing services, repricers, health plans, clearinghouses and non-emergency transportation services as examples.
A provider who never bills electronically may not be required to get an NPI. Anyone enrolling in Medicare, however, must have one.
NPI-1 vs. NPI-2: What's the Difference?
NPPES sorts providers into two entity types: Entity Type 1 and Entity Type 2, usually shortened to NPI-1 and NPI-2. Type 1 is for individuals and Type 2 is for organizations.
| Type | Used for | Example |
|---|---|---|
| NPI-1 (Entity Type 1) | Individual healthcare providers | A pediatrician, a dentist |
| NPI-2 (Entity Type 2) | Healthcare organizations | A hospital, a group practice |
NPI-1: individual providers
An NPI-1 is assigned to an individual healthcare provider, such as a family doctor, a dentist, a pharmacist or a physical therapist.
Each individual can have only one NPI. That holds even if the provider works at several locations or runs a solo practice as a sole proprietor.
NPI-2: healthcare organizations
An NPI-2 is assigned to an organization that provides healthcare, such as a hospital, a group practice, a laboratory or a pharmacy.
An organization can be very large or very small. A doctor who forms a corporation may be the only provider working for it. In that case the doctor has an NPI-1 personally, and the corporation has its own NPI-2.
Large organizations can also get separate NPIs for parts of the business, called subparts. A hospital might have separate NPIs for its lab, pharmacy and rehab unit if each one bills on its own.
What Is NPPES?
NPPES stands for the National Plan and Provider Enumeration System. It is the CMS system that assigns NPIs and stores the information behind them.
“Enumeration” is the term CMS uses for assigning an NPI. NPPES does three main jobs:
- It assigns NPIs to eligible providers.
- It stores and updates each provider's record.
- It publishes the public parts of that information through the NPI Registry and downloadable data files.
Providers apply for an NPI and update their details through NPPES. The NPI is the number; NPPES is the system that manages it. They are related, but they are not the same thing.
What Is the NPI Registry?
The NPI Registry is the free public search tool for NPPES data. CMS runs it at npiregistry.cms.hhs.gov (opens in a new tab), and anyone can use it to look up a provider by NPI, by name or by other details.
CMSoperates NPPESpublishes public data through the NPI Registry
The Registry is query-only: you can search and view records, but not change them. Information in it is updated daily. It shows only data that can be released under the Freedom of Information Act, so sensitive details such as Social Security numbers are not shown.
The Registry is a directory, not a review or verification service. It shows what providers have reported to NPPES. It does not check or rate their qualifications.
What Information Can You Find With an NPI Lookup?
An NPI lookup shows the public parts of a provider's NPPES record. Records vary, but a typical one may include:
- The NPI itself
- The provider's name (NPI-1) or legal business name (NPI-2)
- Other names, such as a former name or a “doing business as” name
- Entity type: individual or organization
- Credentials the provider reported, such as MD or DDS
- Taxonomy codes and descriptions, with one marked as primary
- A license number and state reported alongside a taxonomy
- Primary practice location address and phone number
- Mailing address
- Additional practice locations, if reported
- Enumeration date (when the NPI was assigned)
- Last updated date
- NPI status
- For organizations, an authorized official's name and title
Not every record has every field. The information is reported by the provider or someone acting for them, so how current it is depends on whether the provider has kept it up to date.
What Is an NPI Taxonomy Code?
A taxonomy code is a 10-character code, made of letters and numbers, that describes what kind of provider someone is and their area of specialization. Its full name is the Health Care Provider Taxonomy Code. The National Uniform Claim Committee (NUCC) (opens in a new tab) maintains the code set, not CMS.
The code set has three levels:
- Provider grouping: a broad category, such as physicians or dental providers
- Classification: a more specific type, such as internal medicine
- Area of specialization: a narrower focus, if one applies
When providers apply for an NPI, they choose the code or codes that best describe their practice. They can pick more than one but must mark one as primary. The taxonomy is stored in the provider's NPPES record, not in the number.
The taxonomy code is not part of the NPI. The NPI stays the same even if the provider later changes their taxonomy.
How to Look Up an NPI Number
You can look up an NPI in a few minutes with a free tool.
Open an NPI lookup tool
Use the official NPPES NPI Registry (opens in a new tab) or the HCPContacts NPI Lookup, which searches public NPPES information.
Enter the NPI if you have it
An exact 10-digit NPI should return one record.
Otherwise, search by provider details
Use the provider's first and last name, or an organization's name.
Narrow the results
Add a city, state or ZIP code if the name is common. A specialty or provider type can narrow it further.
Review the matching record
Check the name, entity type, taxonomy and practice location to make sure you have the right provider.
If a search finds nothing, check the number for typos first. The Registry lists active NPIs, so a provider whose NPI has been deactivated may not appear.
Can You Find an NPI Without Knowing the Number?
Yes. You can search by name instead of by number: a first and last name for an individual, or the organization name for an organization.
The NPI Registry's search form also lets you filter by city, state, ZIP code, country, taxonomy description and NPI type. These filters help when many providers share the same name.
A state on its own is too broad; the Registry asks for more criteria alongside it. Combine the state with a name, city, ZIP code or specialty for useful results.
Does an NPI Number Expire?
No. CMS describes the NPI as a lasting identifier, and there is no expiration date or renewal cycle for it.
An NPI can, however, be deactivated: for example when a provider dies, when an organization dissolves, or when the number has been used fraudulently. A deactivated NPI is never reassigned to anyone else, and in some cases it can be reactivated through NPPES or the NPI Enumerator, the contractor that processes NPI applications for CMS.
“Does not expire” is also different from “is current.” The information attached to an NPI can go out of date while the number stays active.
Can an NPI Number Change?
Usually not. CMS expects an NPI to stay the same even when a provider changes their name, address, taxonomy or other details.
CMS does describe a few exceptions:
- Changes of ownership: when an organization is sold or restructured, it may need a new NPI.
- Fraud: if an NPI has been used fraudulently, the provider may need a new one.
For individual providers these situations are rare. Most doctors keep the same NPI for their whole career, even if they change jobs or states.
What Happens When a Provider's Information Changes?
The provider updates their NPPES record, and the NPI stays the same. Typical updates include:
- A new practice address or mailing address
- A name change
- A new or different taxonomy
- A new phone number or other contact details
HIPAA-covered providers must report changes to their required NPPES information within 30 days. Most updates can be made online in NPPES. Some requests, such as certain deactivation or reactivation requests, may need the paper NPI Application/Update Form (CMS-10114).
Updating NPPES does not update other systems. Medicare enrollment, for example, is managed separately through PECOS, the Medicare enrollment system, so records in different systems can disagree for a while.
NPI Number vs. Medical License Number
An NPI identifies a provider; a license gives them legal permission to practice. People often confuse the two numbers, but they do different jobs.
| NPI | Medical license | |
|---|---|---|
| Purpose | Identifies a provider in healthcare transactions | Gives legal permission to practice |
| Issued by | CMS, through NPPES | The relevant licensing authority, usually a state board |
| Scope | National | Usually one state or jurisdiction |
| Renewal | No renewal cycle | Renewed on a schedule the licensing authority sets |
| Proves current licensure? | No | The licensing authority's record is the source |
Some NPPES records list a license number next to a taxonomy. That entry is self-reported and does not confirm the license is active.
NPI Number vs. Taxonomy Code
An NPI tells you who the provider is. A taxonomy code tells you what kind of provider they are.
| NPI | Taxonomy code | |
|---|---|---|
| Answers | “Which provider is this?” | “What type of provider is this?” |
| Format | 10 digits | 10 characters, letters and numbers |
| Maintained by | CMS, through NPPES | NUCC |
| How many per provider | One per individual | One or more, with one primary |
| Can it change? | Rarely | Yes, when the practice focus changes |
A provider has one NPI but may list several taxonomy codes. A nurse practitioner who works in both family care and psychiatric care, for example, might list two taxonomies under the same NPI.
What an NPI Number Does Not Tell You
An NPI proves that a number was assigned to a provider in NPPES, and not much else. According to CMS, getting an NPI does not:
- Ensure the provider is licensed or credentialed
- Enroll the provider in Medicare or any other health plan
- Guarantee that a health plan will pay the provider
An NPI also should not be treated as evidence of:
- Current licensure: check with the licensing authority.
- Board certification: check with the certifying board.
- Credentialing status: hospitals and health plans run their own credentialing.
- Current employment: a listed practice address may be out of date.
- Quality of care or professional standing: the NPI Registry does not rate providers.
An NPPES record can still hold useful details, such as credentials, a taxonomy or a reported license number. Those details are reported by the provider, so use the record as a starting point and confirm important facts with the official source for each one.
Common Reasons to Look Up an NPI Number
People look up NPIs for many everyday reasons:
- Finding a provider's NPI to complete a claim, referral or form
- Confirming that a name and an NPI belong to the same record
- Checking basic details such as a practice address or phone number
- Reviewing a provider's specialty through their taxonomy
- Telling apart providers with similar names by comparing location and taxonomy
- Finding an organization's NPI-2 for billing or network lists
- Researching providers or organizations in a certain area or specialty
An NPI lookup is built for checking one provider at a time. Reaching a whole group of healthcare professionals is a different job; learn how an HCP database works if that is what you need.
NPI Lookup Example
The provider, place and details below are invented for illustration. They do not refer to a real person or NPI record.
Hypothetical example
- Provider name + location
- Search
- Several matches
- Compare taxonomy and practice details
- Pick the right record
Suppose you need the NPI for a family doctor you know as “Dr. Alex Rivera” in Springfield, Illinois, and you do not know the number.
- You open an NPI lookup tool and enter “Alex” as the first name and “Rivera” as the last name.
- The search returns several matches across different states.
- You add “Springfield” as the city and “IL” as the state. Two records remain.
- One record lists a family medicine taxonomy. The other lists physical therapy.
- You open the family medicine record, confirm the practice address is what you expected, and copy the NPI.
Name plus location usually narrows the results, and taxonomy often settles which record is the right one.
Looking Up an NPI on HCPContacts
HCPContacts offers a free NPI Lookup for searching publicly available NPPES information. You can search by NPI number, or by provider details (first and last name or organization name, specialty, city, state and ZIP code, and individual or organization type) and view the matching public record.
The NPI data comes from NPPES, which CMS operates. HCPContacts did not create NPPES and does not run it, issue NPIs or verify provider credentials. For official confirmation, the NPPES NPI Registry (opens in a new tab) remains the primary source.
Frequently Asked Questions About NPI Numbers
NPI stands for National Provider Identifier. It is the standard ID number for healthcare providers in U.S. healthcare transactions.
An NPI has exactly 10 digits, all numbers. The last digit is a check digit that helps catch typing errors.
CMS assigns NPIs through NPPES, the National Plan and Provider Enumeration System. Providers apply online through NPPES or send a paper application to the NPI Enumerator, the contractor that processes NPI applications for CMS.
Yes. Anyone can search an NPI and the public parts of a provider's record for free in the NPPES NPI Registry. Sensitive details, such as Social Security numbers, are not published.
No. A license comes from a licensing authority, usually a state board, and gives a provider legal permission to practice. An NPI only identifies the provider in healthcare transactions.
An NPI-1 (Entity Type 1) belongs to an individual provider, such as a physician or dentist. An NPI-2 (Entity Type 2) belongs to an organization, such as a hospital or group practice. A doctor can have an NPI-1 personally while the practice they incorporated has an NPI-2.
An individual provider can have only one NPI. Organizations are different: a healthcare organization may get separate NPIs for subparts, and an incorporated provider may have a personal NPI-1 plus an NPI-2 for the business.
Yes. Search by first and last name for an individual, or by organization name. Adding a city, state or ZIP code helps when many providers share the same name.
No. The NPI has no expiration date and no renewal cycle. It can, however, be deactivated, for example after a provider's death, when an organization closes, or when the number has been used fraudulently.
A 10-character code from the NUCC Health Care Provider Taxonomy code set that describes a provider's type and specialization. Providers choose their own codes, may list more than one, and mark one as primary. The code is separate from the NPI.
No. NPPES states that issuing an NPI does not ensure or validate that a provider is licensed or credentialed. Check licensure with the relevant licensing authority.
The NPI or name may have been typed incorrectly, the provider may be listed under a different name or location, or the NPI may have been deactivated. Try fewer search fields, then add filters one at a time.
Related Resources
Sources
- CMS: National Provider Identifier Standard (NPI) (opens in a new tab)
- CMS (Medicare Learning Network): NPI: What You Need to Know (opens in a new tab)
- CMS: Unique Identifiers FAQs (opens in a new tab)
- CMS: Data Dissemination (NPPES) (opens in a new tab)
- CMS / HHS: NPPES NPI Registry (opens in a new tab)
- CMS / HHS: NPPES (application and update system) (opens in a new tab)
- CMS: NPPES Downloadable Files (NPI Files) (opens in a new tab)
- CMS: Find Your Taxonomy Code (opens in a new tab)
- NUCC: Health Care Provider Taxonomy Code Set (opens in a new tab)
- CMS: NPI Application/Update Form (CMS-10114) (opens in a new tab)
- HHS (via govinfo.gov): 45 CFR Part 162, Subpart D: Standard Unique Health Identifier for Health Care Providers (opens in a new tab)