Healthcare Provider Verification — NPPES/NPI

Credentialing services, insurance networks, and patients currently verify a healthcare provider's NPI (National Provider Identifier) status by hand, on CMS's own NPPES lookup. Free, public, keyless. This turns a name/NPI/organization search into a verified provider record: active status, specialty, and practice address.

Input

{ "providers": [{ "organizationName": "Mayo Clinic" }] }

Query by npi, organizationName, or firstName/lastName — one identifying field is required per entry; state is optional to narrow results.

Sample output

{
  "npi": "1881018208",
  "enumerationType": "NPI-2",
  "name": "MAYO CLINIC",
  "isOrganization": true,
  "status": "A",
  "isActive": true,
  "practiceCity": "ROCHESTER",
  "practiceState": "MN"
}

Typical uses

• Credentialing / provider network verification — confirm an NPI is active and matches the claimed specialty before onboarding.
• Insurance network validation — bulk-check a provider roster's NPI status.
• Patient due diligence — verify a provider's credentials before a visit.
• Fraud/compliance screening — a deactivated or mismatched NPI is a real signal worth investigating.

Pricing

$0.002 per provider record.

⚠️ Read before you act

• Covers both individual (NPI-1) and organization (NPI-2) providers — isOrganization tells you which; a search by organization name naturally returns NPI-2 records, a name search returns NPI-1.
• isActive reflects NPPES's own current status — deactivation isn't necessarily fraud; providers retire, close practices, or merge organizations. Treat it as a signal to investigate, not a verdict.
• The practice address is the LOCATION address, not the mailing address, when both are on file — the one relevant to "where do they actually practice."

FAQ

• Do I need an API key? No — NPPES's registry API is free and keyless.
• What's the difference between NPI-1 and NPI-2? NPI-1 is an individual provider (a doctor, nurse, therapist); NPI-2 is an organization (a clinic, hospital, group practice).
• Can I search by license number? Not directly — NPPES doesn't expose a license-number search parameter; search by name/NPI/organization and check the returned licenseNumber field instead.

Related actors

• Nonprofit Financial Lookup — the same official-registry-verification pattern, for nonprofit financial data instead of healthcare credentials.
• Financial Complaint Monitor — another regulated-entity lookup, for CFPB financial company complaints.