Community Resources

Information on Medicare Provider-Supplier Enrollment can be found on the US Department of Health & Human Services web site.

CAQH registration and other information on the Council for Affordable Quality Healthcare's Universal Provider Data Source can be found on the CAQH web site.

For information on enrolling in particular private health care networks, please contact the specific network.

Medical States Board, Physician Licensing & Credentialing Information

Alaska

550 West Seventh Avenue, Suite 1500
Anchorage, Alaska 99501
(907) 269-8163
(907) 269-8196

Physician Licensee Search State Medical Board Physician Licensing Information

Alabama

P.O. Box 946
Montgomery, Alabama 36101-0946
(334) 242-4116
(334) 242-4155

Physician Licensee Search State Medical Board Physician Licensing Information Alabama Unform Provider Application

Arkansas

2100 Riverfront Drive
Little Rock, Arkansas 72202-1793
(501) 296-1802
(501) 603-3555

Physician Licensee Search State Medical Board Physician Licensing Information

Arizona

9545 East Doubletree Ranch Road
Scottsdale, Arizona 85258-5514
(480) 551-2700
(480) 551-2704

Physician Credentialing State Medical Board Physician Licensing Information

California

2720 Gateway Oaks Dr. Suite 350
Sacramento, California 95833
(916) 263-3100
(916) 263-3117

Physician Credentialing State Medical Board Physician Licensing Information Medical Board Of California

Colorado

Denver, Colorado 80202-5140
(303) 894-7690
(303) 894-7692

State Medical Board Physician Licensing Information Physician Credentialing Colorado Health Care Professionals Credentials Application

Connecticut

P.O. Box 340308
Hartford, Connecticut 06134-0308
(860) 509-7648
(860) 509-7553

State Medical Board Physician Licensing Information Physician Credentialing

District of Columbia

717 14th Street, NW Suite 600
Washington, District of Columbia 20005
(202) 724-4900
(202) 727-8471

State Medical Board Physician Licensing Information DC Uniform Credentialing/Recredentialing Provider Application

Delaware

P.O. Box 1401
Dover, Delaware 19903
(302) 739-4522
(302) 739-2711

Medical Board Physician Licensing Information Physician Credentialing

Florida - DO

4052 Bald Cypress Way, BIN C06
Tallahassee, FL 32399-1753
(850) 245-4161
(850) 487-9874

State Medical Board Physician Licensing Information Physician Credentialing

Florida - MD

4052 Bald Cypress Way BIN #C03
Tallahassee, FL 32399-3253
(850) 245-4131
(850) 488-9325

State Medical Board Physician Licensing Information Physician Credentialing

Georgia

2 Peachtree Street, N.W., 36th floor
Atlanta, Georgia 30303
(404) 656-3913
(404) 656-9723

State Medical Board Physician Licensing Information Physician Credentialing Georgia Uniform Healthcare Practitioner Credentialing Application

Guam

1304 East Sunset Boulevard
Barrigada, Guam 96913
(671) 475-2512
(671) 477-4733

Hawaii

P.O. Box 3469
Honolulu, Hawaii 96813
(808) 586-3000
(808) 586-2874

State Medical Board Physician Licensing Information Physician Credentialing

Iowa

400 Southwest Eighth Street Suite C
Des Moines, Iowa 50309-4686
(515) 281-5171
(515) 242-5908

State Medical Board Physician Licensing Information Physician Credentialing Iowa Association Medical Staff Services Universal Application

Idaho

1755 Westgate Drive Suite 140
Boise, Idaho 83704
(208) 327-7000
(208) 327-7005

State Medical Board Physician Licensing Information Physician Credentialing

Illinois

320 W. Washington St., 3rd Floor
Springfield, Illinois 62786
(217) 785-0800
(217) 524-2169

State Medical Board Physician Licensing Information Physician Credentialing Illinois Health Care Credentials & Data Collection Act forms

Indiana

402 W. Washington Street Room W072
Indianapolis, Indiana 46204
(317) 232-2960
(317) 233-4236

State Medical Board Physician Licensing Information Physician Credentialing

Kansas

235 South Topeka Blvd.
Topeka, Kansas 66603-3068
(785) 296-7413
(785) 296-0852

State Medical Board Physician Licensing Information Physician Credentialing

Kentucky

310 Whittington Parkway Suite 1-B
Louisville, Kentucky 40222
(502) 429-7150
(502) 429-7158

State Medical Board Physician Licensing Information Physician Credentialing Kentucky Application For Provider Evaluation & Reevaluation Form

Louisiana

P.O. Box 30250
New Orleans, Louisiana 70190-0250
(504) 568-6820
(504) 568-8893

State Medical Board Physician Licensing Information Physician Credentialing Louisiana Standardized Credentialing Application

Massachusetts

560 Harrison Ave. Suite G-4
Boston, Massachusetts 02118
(617) 654-9800
(617) 451-9568

State Medical Board Physician Licensing Information Physician Credentialing Massachusetts Uniform Credentialing Application

Maryland

P.O. Box 2571
Baltimore, Maryland 21215-0095
(410) 764-4777
(410) 358-2252

State Medical Board Physician Licensing Information Physician Credentialing Maryland Uniform Credentialing Form

Maine - DO

142 State House Station
Augusta, Maine 04333-0142
(207) 287-2480
(207) 287-3015

State Medical Board Physician Licensing Information Physician Credentialing

Maine - MD

137 State House Station
Augusta, Maine 04333
(207) 287-3601
(207) 287-6590

State Medical Board Physician Licensing Information Physician Credentialing Maine Physician Application For Appointment

Michigan

P.O. Box 30670
Lansing, Michigan 48909-8170
(517) 335-0918
(517) 373-2179

State Medical Board Physician Licensing Information Physician Credentialing Michigan Association Of Health Plans Standard Practitioner Application

Minnesota

2829 University Avenue, S.E. Suite 500
Minneapolis, Minnesota 55414-3246
(612) 617-2130
(612) 617-2166

State Medical Board Physician Licensing Information Physician Credentialing Minnesota Credentialing Collaborative

Missouri

3605 Missouri Blvd.
Jefferson City, Missouri 65109
(573) 751-0098
(573) 751-3166

State Medical Board Physician Licensing Information Physician Credentialing

Mississippi

1867 Crane Ridge Drive Suite 200B
Jackson, Mississippi 39216
(601) 987-3079
(601) 987-4159

State Medical Board Physician Licensing Information Physician Credentialing

Montana

P.O. Box 200513
Helena, Montana 59620-0513
(406) 841-2300
(406) 841-2363

Medical Board Physician Licensing Information Physician Credentialing Missouri Standardized Credentialing Form

North Carolina

P.O. Box 20007
Raleigh, North Carolina 27619
(919) 326-1100
(919) 326-1130

State Medical Board Physician Licensing Information Physician Credentialing North Carolina Uniform Application To Participate As A Health Care Practitioner

South Carolina

P.O. Box 20007
Raleigh, North Carolina 27619
(919) 326-1100
(919) 326-1130

State Medical Board Physician Licensing Information Physician Credentialing North Carolina Uniform Application To Participate As A Health Care Practitioner

North Dakota

418 E. Broadway Avenue Suite 12
Bismarck, North Dakota 58501
(701) 328-6500
(701) 328-6505

State Medical Board Physician Licensing Information Physician Credentialing

South Dakota

418 E. Broadway Avenue Suite 12
Bismarck, North Dakota 58501
(701) 328-6500
(701) 328-6505

State Medical Board Physician Licensing Information Physician Credentialing

Nebraska

P.O. Box 94986
Lincoln, Nebraska 68509-4986
(402) 471-2118
(402) 471-3577

State Medical Board Physician Licensing Information Physician Credentialing Nebraska Health & Human Services Licensure Application

New Hampshire

2 Industrial Park Drive Suite 8
Concord, New Hampshire 03301-8520
(603) 271-1203
(603) 271-6702

State Medical Board Physician Licensing Information Physician Credentialing New Hampshire Uniform Application For Credentialing

New Jersey

P.O. Box 183
Trenton, New Jersey 08625-0183
(609) 826-7100
(609) 826-7117

State Medical Board Physician Licensing Information Physician Credentialing New Jersey Universal Physician Credentialing Form

New Mexico - DO

2550 Cerrillos Road
Santa Fe, New Mexico 87501-5101
(505) 476-4695
(505) 476-4645

State Medical Board Physician Licensing Information Physician Credentialing

New Mexico - MD

2055 S. Pacheco Building 400
Santa Fe, New Mexico 87505
(505) 476-7220
(505) 476-7237

State Medical Board Physician Licensing Information Physician Credentialing New Mexico Statewide Application For Physician/Practitioner Appointment

Nevada - DO

2860 E. Flamingo Rd. Suite G
Las Vegas, Nevada 89121
(702) 732-2147
(702) 732-2079

State Medical Board Physician Licensing Information Physician Credentialing Nevada Uniform Credentialing Form

Nevada - MD

1105 Terminal Way Suite 301
Reno, Nevada 89502
(775) 688-2559
(775) 688-2321

State Medical Board Physician Licensing Information Physician Credentialing

New York

89 Washington Avenue 2nd floor, West Wing
Albany, New York 12234
(518) 474-3817
(518) 486-4846

State Medical Board Physician Licensing Information Physician Credentialing

Ohio

30 E. Broad St. 3rd Floor
Columbus, Ohio 43215-6127
(614) 466-3934
(614) 728-5946

State Medical Board Physician Licensing Information Physician Credentialing

Oklahoma - DO

4848 N. Lincoln Blvd. Suite 100
Oklahoma City, Oklahoma 73105-3321
(405) 528-8625
(405) 557-0653

State Medical Board Physician Licensing Information Physician Credentialing Oklahoma Uniform Credentialing Application

Oklahoma - MD

P.O. Box 18256
Oklahoma City, Oklahoma 73118
(405) 848-6841
(405) 848-8240

State Medical Board Physician Licensing Information Physician Credentialing

Oregon

1500 SW First Avenue Suite 620
Portland, Oregon 97201-5826
(971) 673-2700
(971) 673-2670

State Medical Board Physician Licensing Information Physician Credentialing Oregon Practicioner Credentialing Application

Pennsylvania - DO

P.O. Box 2649
Harrisburg, Pennsylvania 17105-2649
(717) 783-4858
(717) 787-7769

State Medical Board Physician Licensing Information Physician Credentialing

Pennsylvania - MD

P.O. Box 2649
Harrisburg, Pennsylvania 17105-2649
(717) 787-2381
(717) 787-7769

State Medical Board Physician Licensing Information Physician Credentialing

Puerto Rico

P.O. Box 13969
San Juan, Puerto Rico 00908
(787) 782-8937
(787) 706-0304

Rhode Island

Cannon Building, Room 205 Three Capitol Hill
Providence, Rhode Island 02908-5097
(401) 222-3855
(401) 222-2158

State Medical Board Physician Licensing Information Physician Credentialing

Tennessee - DO

227 French Landing Suite 300 Heritage Place MetroCenter
Nashville, Tennessee 37243
(800) 778-4123
(615) 253-4484

State Medical Board Physician Licensing Information Physician Credentialing

Tennessee - MD

227 French Landing Suite 300 Heritage Place MetroCenter
Nashville, Tennessee 37243
(800) 778-4123
(615) 253-4484

State Medical Board Physician Licensing Information Physician Credentialing

Texas

P.O. Box 2018
Austin, Texas 78768-2018
(512) 305-7010
(512) 305-7008

State Medical Board Physician Licensing Information Physician Credentialing Texas Standardized Credentialing Application

Utah

160 E. 300 South, 84102 Heber M. Wells Building, 4th Floor
Salt Lake City, Utah 84114
(801) 530-6628
(801) 530-6511

State Medical Board Physician Licensing Information Physician Credentialing

Virginia

6603 W. Broad St. 5th Floor
Richmond, Virginia 23230-1717
(804) 662-9908
(804) 662-9517

State Medical Board Physician Licensing Information Physician Credentialing

Vermont - DO

Office of Professional Regulation National Life Bldg., North Fl 2
Montpelier, Vermont 05620-3402
(802) 828-1134

State Medical Board Physician Licensing Information Physician Credentialing

Vermont - MD

108 Cherry Street
Burlington, Vermont 05401
(802) 657-4220
(802) 657-4227

State Medical Board Physician Licensing Information Physician Credentialing Vermont Provider Application Form

Washington - DO

P.O Box 47866
Olympia, Washington 98504-7866
(360) 236-4945
(360) 236-2406

State Medical Board Physician Licensing Information Physician Credentialing

Washington - MD

310 Israel Road S.E. MS 47866
Tumwater, Washington 98501
(360) 236-4788
(360) 236-4768

State Medical Board Physician Licensing Information Physician Credentialing

Wisconsin

1400 E. Washington Ave.
Madison, Wisconsin 53703
(608) 266-2112
(608) 261-7083

State Medical Board Physician Licensing Information Physician Credentialing

West Virginia - DO

334 Penco Rd.
Weirton, West Virginia 26062
(304) 723-4638
(304) 723-2877

State Medical Board Physician Licensing Information Physician Credentialing

West Virginia - MD

101 Dee Drive
Charleston, West Virginia 25311
(304) 558-2921
(304) 558-2084

State Medical Board Physician Licensing Information Physician Credentialing West Virginia Uniform Credentialing Application Forms

Wyoming - WY

211 W. 19th St., Colony Bldg. 2nd Floor
Cheyenne, Wyoming 82002
(307) 778-7053
(307) 778-2069

State Medical Board Physician Licensing Information Physician Credentialing