Data sources / Licensing and regulatory
NPPES NPI Registry
Public National Provider Identifier records for enumerated healthcare providers, including individuals and organizations. Provider enumeration differs from professional licensing, credentialing and the ownership structure of a practice.
Last reviewed · report an error
- Publisher
- Centers for Medicare & Medicaid Services
- Access
- Free
- Coverage
- Public National Provider Identifier records for enumerated healthcare providers, including individuals and organizations. Provider enumeration differs from professional licensing, credentialing and the ownership structure of a practice.
- Identifiers
- NPI; Provider taxonomy code; Entity type
- Freshness
- varies
- Official URL
- https://npiregistry.cms.hhs.gov/
What it can establish
Use NPPES NPI Registry for a defined acquisition-research question. Match each record to the right entity using its identifiers (NPI, Provider taxonomy code, Entity type) before accepting its contents, and keep Centers for Medicare & Medicaid Services's own scope and attribution on the finding.
- The NPI and publicly reported provider name, entity type, taxonomy and address information visible in the record.
- An identity lead connecting a healthcare operating name to a provider record, subject to entity and location checks.
What it cannot establish
- Current professional licensure, payer participation, clinical quality or eligibility to perform a specific service solely from enumeration.
- The number of independent practices, the practice's beneficial owners or whether several provider records belong to one acquisition perimeter.
A search that returns nothing in NPPES NPI Registry describes the search performed. Coverage here is public National Provider Identifier records for enumerated healthcare providers, including individuals and organizations, so a missing record becomes a negative finding only where that coverage reaches the company in question and the evidence standard supports the inference. Otherwise the question stays open.
How Docket uses it
Your acquisition criteria become the agents' questions. NPPES NPI Registry can support some of them and leave others unanswered; its freshness (varies) is weighed answer by answer and it receives no blanket reliability score.
- Triage. Distinguishes organization records from individual clinicians and checks whether each belongs to the intended practice.
- Scout. Collects the published taxonomy and location statements while retaining provider type and record context.
- Audit. Checks that enumeration has not been described as licensing, and that multiple records have not become duplicate target companies.
Scout records typed answers from a fixed list with verbatim quotations from retained pages. Audit reviews only the retained material, with every fetch tool denied. It settles supported contradictions, strikes unquotable answers and leaves gaps visible. See the research-agent method and screening criteria guide for the surrounding workflow.
Pitfalls and review questions
- A mailing address can differ from a practice location, and old provider information can remain discoverable.
- A clinician, organization and practice brand can each require separate identity resolution. Confirm the operating relationship before using provider counts as a proxy for practice size.
What the registry holds
The National Plan and Provider Enumeration System assigns National Provider Identifiers to healthcare providers, and the NPI Registry makes the records public. There are two kinds. Individual providers have Type 1 numbers, and organisations such as practices, clinics and hospitals have Type 2. A record shows the name, the practice location, taxonomy codes describing the provider's specialty, licence information the provider reported, and, for organisations, an authorised official.
The identifier is required under a federal standard for covered healthcare transactions. The Centers for Medicare & Medicaid Services publishes full and update files for bulk analysis. Because enumeration is a precondition for billing electronically, the registry gives wide coverage of providers who bill insurers.
What it does not show
The registry does not show who owns an organisation. An authorised official is a person the organisation names, which may be a manager and not an owner. Records are submitted by providers and are updated by them, so addresses, specialties and status can be stale, and a deactivated number remains in the history. A Type 2 number may belong to a billing entity covering several sites, or a site may use the owner's number.
Counts of NPIs are counts of numbers. A practice with six clinicians typically appears as one organisation and six individuals, perhaps with several organisation numbers. Reconstructing the practice therefore means grouping numbers by address, authorised official and affiliations, and recording the grouping rule. Ownership requires other sources, such as the provider enrolment ownership data.
Illustration (fictional)
A researcher mapping physical therapy practices in a metropolitan area pulls Type 2 records with the relevant taxonomy. Three share an address and authorised official. The researcher groups them as one practice with three billing numbers, counts the Type 1 records at that address as clinicians, and records the grouping logic so that a reviewer can check it.
Related sources
Filings and registries
State business registries
Company-published
Company websites
Company-published
Professional profiles
Relevant sector playbooks
Related reference pages and articles
- Playbook: physical therapy
- Playbook: dental practices
- Playbook: veterinary practices
- Thesis: multi-site practice platforms
- Article: NPPES data for healthcare market mapping
- Article: CMS PECOS ownership data
Sources and further reading
- NPPES NPI Registry, Centers for Medicare & Medicaid Services. The public lookup for National Provider Identifiers.
- NPPES NPI files, Centers for Medicare & Medicaid Services. Bulk monthly and weekly files of provider records.
- National Provider Identifier Standard (NPI), Centers for Medicare & Medicaid Services. What the NPI is for and which providers must have one.
- A Theory for Record Linkage, Journal of the American Statistical Association (1969). The foundational probabilistic model for deciding whether two records describe the same entity.
These links identify research contexts to investigate, rather than conclusions about sector attractiveness. Ask how NPPES NPI Registry would be used on your list or return to the complete source directory.
Send us ten targets. We research them for free.
A target list and your acquisition criteria are enough. You get back company records with scores, the evidence behind every field, and the questions the public record could not answer.