Provider Enrollment Portal (PEP)

Checklist

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Hospital
Audiologist Group
Ambulatory Surgical Center
Skilled Nursing Facility - Hospital Based
Skilled Nursing Facility - Free Standing
Intermediate Care Facility for Individuals with Intellectual Disabilities Facility- State
Intermediate Care Facility for Individuals with Intellectual Disabilities Facility- Private
Hospice
Chiropractor Group
Dentist Group
Federally Qualified Health Center - Look Alike
Pharmacy
Pharmacist
Imaging Center
Physician
Podiatrist
Chiropractor
Physician Assistant
Nurse Practitioner
Social Worker
Midwife
Dentist
Midwife Group
Ambulance
Non Emergency Medical Transportation
Nutritionist Dietician Group
Occupational Therapist Group
Laboratory
Certified Registered Nurse Anesthetist
Occupational Therapist
Speech Language Pathologist
Comprehensive Outpatient Rehabilitation Facility
Hearing Aid Supplier
Physical Therapy Group
Audiologist
Optometrist
Optometrist Group
Home Health Agency
Federally Qualified Health Center
Psychologist
Physical Therapist
Physician Group
Psychologist Group
Dialysis Center
Durable Medical Equipment
Speech Language Pathologist Group
Podiatrist Group
Developmental Disability Center
Nutritionist Dietician
Infusion Center Agency
Vision Center
Prosthesis and Orthotics
Implant Supplier
Wound Centers
Vaccination Centers
Multi disciplinary Group
Center for Diagnosis and Treatment
External Clinic - Hospital Based
Family Planning Center
Imaging Center Mobile
Mental Health Center
Methadone Center (MET) / Buprenorphine Service (BUP)
Licensed Marriage Counselor
Pediatric Center
Primary Care Center
Inpatient Rehabilitation Facility
Urgent Care Center
Certified Addiction Counselor