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NC Division of Medical Assistance |
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Get It! Share It! Use It!
Getting one is free -
Not having one can be costly!
Last Updated December 12, 2008
N.C. Medicaid has designed a mapping solution to crosswalk the NPI to the Medicaid Provider Number. Ideally, each NPI will crosswalk to only one Medicaid Provider Number. If the NPI crosswalks to multiple Medicaid Provider Numbers, the mapping solution will attempt to determine the appropriate Medicaid Provider Number by taking the claim through a series of steps. The taxonomy will play an important role in determining the appropriate Medicaid Provider Number to use for claim processing.
Therefore, N.C. Medicaid strongly recommends that providers use the table below when choosing an appropriate taxonomy. This will assist N.C. Medicaid in crosswalking to the correct Medicaid Provider Number in the event the provider chooses not to apply for a unique NPI for each of its Medicaid Provider Numbers.
Note: The taxonomies recommended below are to be used for claims processing only. Providers are not required to change the taxonomy that was previously reported to NPPES or N.C. Medicaid Provider Enrollment. Currently, N.C. Medicaid does not compare the taxonomy submitted on claims to what was reported to Provider Enrollment or NPPES.
| Provider Type/Service Provided | Taxonomy Code |
|---|---|
| Adult Care Home Enhanced Level of Care | 310400000X |
| Adult Care Home Level of Care | 310400000X |
| Adult Care Home Special Care Alzheimer’s Level of Care | 311500000X |
| Ambulance | 341600000X |
| Area Mental Health (LME) | 261QM0801X |
| Audiologists Group/Individual | 231H00000X |
| Case Management Services | 251B00000X (MCC and CSC) 2084P0015X (At Risk and HIV) |
| Chiropractic Group/Individual | 111N00000X |
| Clinical Nurse Specialist – Mental Health/Psychiatric | 364SP0808X |
| Community Intervention Services (All Enhanced Benefits | 251S00000X |
| Durable Medical Equipment | 332B00000X |
| Federally Qualified Health Clinic (FQHC) – All services | 261QF0400X |
| Health Department – All Services | 251K00000X 261QP0905X |
| Hearing Aid Dealer – Hearing Aid | 237700000X |
| Home Health | 251E00000X |
| Home Infusion Therapy (HIT) | 251F00000X |
| Hospice Services Provided at Any Location | 251G00000X |
| Hospital – Critical Access | 282NC0060X |
| Hospital – General Services | 282N00000X |
| Hospital – Psychiatric Services (‘S’ suffix on Medicaid Provider Number) | 273R00000X |
| Hospital – Rehabilitation Services (‘T’ suffix on Medicaid Provider Number) | 273Y00000X 276400000X |
| Independent and Outpatient Mental Health Services – Group | Any of the Behavioral Health and Social Service Taxonomies |
| Multiple Independent Practitioner - Group | 193200000X |
| Nurse Practitioners – All Services except psychiatric related services | 363L00000X |
| Nurse Practitioners – Mental Health/Psychiatric | 363LP0808X |
| Nursing Home – Head Level of Care | 364SP0813X 310500000X |
| Nursing Home – Vent Level of Care | 2278S1500X |
| Nursing Home – Indian Facility Billing Intermediate Nursing Level of Care | 313M00000X |
| Nursing Home – Indian Facility Billing Skilled Nursing Level of Care | 314000000X |
| Nursing Home - Intermediate Care Level of Care | 313M00000X |
| Nursing Home - Skilled Nursing Level of Care | 314000000X |
| Occupational Therapists Group/Individual | 225X00000X |
| Optical Supply Dealer – Optician | 156FX1800X |
| Optical Supply Dealer – Eyewear Supplier | 332H00000X |
| Optometry Group/Individual | 152W00000X |
| Personal Care Services | 3747P1801X |
| Pharmacy Prescription Services | 333600000X |
| Physical Therapists Group/Individual | 225100000X |
| Physician - Groups | 193200000X
(Multi-specialty) 193400000X (Single specialty) |
| Physician – Individuals | Any of the Allopathic and Osteopathic Taxonomies |
| Podiatry Group/Individual | 213E00000X |
| Private Duty Nurses | 251J00000X |
| Psychiatric Hospital – Inpatient | 283Q00000X |
| Psychiatric Residential Treatment Facility (PRTF) | 323P00000X |
| Residential Child Care | 322D00000X |
| Respiratory Therapists Group/Individual | 227800000X |
| Rural Health Clinic (RHC) – All Services | 261QR1300X |
| Speech Pathologists Group/Individual | 235Z00000X |
| Swing Bed – Any Facility | 275N00000X |
