Instructions for Taxonomy Change/Update Form

  1. The Provider representative filling out and submitting the form must be a representative with authority to make changes/updates to taxonomy information in Cardinal Innovations' provider data system.
  2. Providers should review their provider profiles at NC Tracks to ensure that any taxonomy changes/updates proposed in the form will end up matching their profiles in NC Tracks. Any taxonomy additions made by submittal of this form should be followed up, if necessary, by a Managed Change Request to NC Tracks to add the taxonomy at NC Tracks if not already reflected at NC Tracks. 
  3. This form may only be used for change/updates to taxonomies for existing billing locations and/or associated rendering practitioners. If the location or associated practitioner is currently not in the Cardinal Innovations system for the provider, the request will be denied. Additionally, only taxonomies may be updated by use of this form. No other data fields in the system may be changed/updated by this form. 
  4. Providers should obtain their Cardinal Innovations provider identification numbers for their site(s) (Provider ID Nos.) for the form from the Cardinal Innovations Provider Direct system. These ID Nos. appear on the Provider Management page in Provider Direct (under the "Admin" tab). For associated practitioners, providers will need the practitioner's NPI No.
  5. The form is separated into sections for additions to Provider site billing taxonomies and additions to associated practitioner rendering taxonomies. Please make sure to fill out the appropriate section for the particular type (billing site versus rendering practitioner) being sought. 
  6. Only those Provider sites' and/or associated Practitioners' taxonomies that need changes/updates should be identified in the spaces in the form.
  7. Any taxonomy added to the form for a site or practitioner must be a valid taxonomy recognized by North Carolina's NC Tracks system, otherwise the request to add the taxonomy will be rejected. Providers must choose the taxonomy from the drop-down menu provided in the form.