396 Delimiter 1 Character, use the ^ character value 397-400 Other Provider Provider Type 1st 2 characters R Identifier Type and Provider are provider type; Code Specialty last 2 characters (3-4) are provider specialty. See PIHP Companion Guide for list of applicable provider types and specialties. 401 Delimiter 1 Character, use the ^ character value 402-409 8 R Provider NPPES Numeric, format Enumeration enumeration YYYYMMDD Date date. 410 Delimiter 1 Character, use the ^ character value 411-418 Last Update NPPES last 8 Numeric, format O Date update date; YYYYMMDD leave all zeros if not available. 419 Delimiter 1 Character, use the ^ character value 420-439 20 O NPI NPPES Left Deactivation deactivation with spaces. Reason Code reason; leave blank if appropriate. 440 Delimiter 1 Character, use the ^ character value 441-448 8 O NPI NPPES Numeric, format Deactivation deactivation YYYYMMDD Date date; leave all zeros if not appropriate.
396 Delimiter 1 Character, use the ^ character value 397-400 Other Provider Identifier Type Code Provider Type and Provider Specialty 1st 2 characters are provider type; last 2 characters (3-4) are provider specialty. See PIHP Companion Guide for list of applicable provider types and specialties. R 401 Delimiter 1 Character, use the ^ character value 402-409 Provider Enumeration Date NPPES enumeration date. 8 Numeric, format YYYYMMDD R 410 Delimiter 1 Character, use the ^ character value 411-418 Last Update Date NPPES last update date; leave all zeros if not available. 8 Numeric, format YYYYMMDD O 419 Delimiter 1 Character, use the ^ character value 420-439 NPI Deactivation Reason Code NPPES deactivation reason; leave blank if appropriate. 20 Left with spaces. O 440 Delimiter 1 Character, use the ^ character value 441-448 NPI Deactivation Date NPPES deactivation date; leave all zeros if not appropriate. 8 Numeric, format YYYYMMDD O
PIHP_CSoC_SystemsCompanionGuide-Sept2018_V12.docx