Out of State Providers

Out-of-State Providers

Out-of-State, Out-of-Network Providers

  • NPI Provider Notification Form - Use this form to register your NPI. Note: This is for out-of-state providers. If you are located in South Carolina, additional forms may be needed/requested.

In-State, Out-of-Network Providers
This section contains forms needed to be added as a non-network provider.