23 Miss. Code. R. 217-1.2

Current through October 31, 2024
Rule 23-217-1.2 - Provider Enrollment
A. Providers of vision services, and those who dispense optical items such as eyeglasses and contacts must satisfy all requirements set forth in Part 200, Chapter 4, Rule 4.8 in addition to the following provider type specific requirements:
1. National Provider Identifier (NPI), verification from National Plan and Provider Enumeration System (NPPES),
2. Copy of licensure card or letter from the appropriate board stating current certification. Card or letter must be from state of servicing location, and
3. Verification of social security number using a social security card, driver's license if it notes the social security number, military ID or a notarized statement signed by the provider noting the social security number. The name noted on verification must match the name noted on the W-9.
B. Written confirmation from the IRS confirming the provider's tax identification number and legal name.

23 Miss. Code. R. 217-1.2

Miss. Code Ann. § 43-13-121; 42 CFR 455, Subpart E