CUT HERE
|
|
- Myra White
- 5 years ago
- Views:
Transcription
1 Template: ARIN-POC-5.0 ** As of XXX 2010 ** Detailed instructions are located below the template. 00. API Key: 01. Registration Action (N,M, or R): 02. Existing POC Handle: ** Skip field 02. if generating a new handle 03. Contact Type (P or R): 04. Last Name or Role Account: 05. First Name: 06. Middle Name: 07. Company Name: 08. Address: 08. Address: 09. City: 10. State/Province: 11. Postal Code: 12. Country Code: 13. Office Phone Number: 14. Office Phone Number Extension: 15. Address: ** OPTIONAL PHONE NUMBERS 16. Mobile: 17. Fax: ** OTHER OPTIONAL FIELDS 18. Public Comments: END OF TEMPLATE If you would like assistance completing this template, please do not hesitate to contact ARIN's Registration Services Help Desk at +1 (703) We'll be glad to help you! CUT HERE TEMPLATE INSTRUCTIONS: Please copy and paste the text-based template into the body of an and send to hostmaster@arin.net with the subject line, "POC TEMPLATE". Please ensure your client sends ARIN the message as plain ASCII text, not as HTML. Please do not attach the template. IMPORTANT NOTE: Do not remove or modify the template header, i.e. the line beginning with "Template:" or the footer, i.e. "END OF TEMPLATE". Both are required for processing. 00. An API Key is a string of characters you can use to identify yourself to ARIN. You must first set up an ARIN Online account
2 and create your API Key. If you are modifying or removing a POC record, your ARIN Online account must be linked to the POC. Find more information about API Keys at: This template allows you to register a new POC, modify information for an existing POC or remove an existing POC not associated with resources in ARIN's database. This registration action is required. Valid values are: N for New M for Modify R for Remove 02. If you are modifying or removing an existing POC, the POC handle is required for processing. If you are registering a new POC in ARIN's Whois database, this field must be blank. If you are unsure of your POC handle, search for your last name in ARIN's Whois database. 03. A POC can be either a person or a role account. A role account is not associated with a particular person, but with an office, position or task and is usually shared by multiple people. Valid values are: P or PERSON for Person R or ROLE for Role The Contact Type cannot be updated. If you are modifying a POC record, this field should be left blank. 04. If the POC is a role account, enter the entire role account name. For example: Last Name or Role Account: Network Operations Center If the POC is a person, enter only the last name. For example: Last Name or Role Account: Smith POC Name cannot be updated. If you are modifying a POC record, this field should be left blank. 05. If the Registration Action is New and the POC is a person, the first name is required. If the POC is a role account, the first name should be left blank. POC Name cannot be updated. If you are modifying a POC record, this field should be left blank. 06. If the POC is a person and has a middle name or initial, provide it in this field. If the POC is a role account, the middle name should be left blank. POC Name cannot be updated. If you are modifying a POC record, this field should be left blank. 07. If the POC is a role, a company name is required. This will help distinguish the Hostmaster from ABC Company from the Hostmaster at XYZ Company. It is optional for persons. If you are modifying a POC that is a person and would like to remove the company name, enter NONE in this field. 08. Indicate the street address of the POC. (If you are modifying the street address of an existing POC, you must include all address lines.) Although the template provides only two address fields, you may duplicate field 08. as many times as necessary to capture the entire address.
3 09. Indicate the city of the POC. 10. Indicate the two-letter abbreviation of the state or province of the POC. 11. Indicate the postal code of the POC. 12. Indicate the ISO-3166 two-character country code of the POC. You can find a complete listing of country codes at: Provide the office telephone number of the POC. Only numbers and the characters + - () are valid. Do not include phone extensions and additional instructions in the phone number field. 14. The phone extension field is free form and can include phone extensions, as well as further instructions to help the caller. If you are modifying a POC record and would like to remove the phone extension, enter NONE in this field. 15. Enter the address of the POC. RFC 2822 describes valid addresses. At least one address is required to process a new POC. To add a second address, duplicate field 15. and include both the current address and the new address on the template. To replace the current address, enter the new address on this line. OPTIONAL PHONE NUMBERS: 16. Provide the mobile telephone number of the POC. Only numbers and the characters + - () are valid. If you are modifying a POC record and would like to remove all mobile phone numbers, enter NONE in this field. 17. Provide the fax telephone number of the POC. Only numbers and the characters + - () are valid. If you are modifying a POC record and would like to remove all fax numbers, enter NONE in this field. OTHER OPTIONAL FIELDS: 18. If there are any comments that you would like publicly displayed in ARIN's Whois, detail them here. If you are modifying a POC record and would like to remove the public comments, enter NONE in this field.
4 Template: ARIN-ORG-5.0 ** As of XXX 2010 ** Detailed instructions are located below the template. 00. API Key: 01. Registration Action (N,M, or R): ** IF REQUESTING A NEW ORG ID, LEAVE FIELD 02. BLANK 02. Existing OrgID: 03. Organization's Legal Name: 04. Organization's D/B/A: 05. Business Tax ID Number (DO NOT LIST SSN): 06. Org Address: 06. Org Address: 07. Org City: 08. Org State/Province: 09. Org Postal Code: 10. Org Country Code: 11. Admin POC Handle: 12. Tech POC Handle: ** OPTIONAL POC HANDLES 13. Abuse POC Handle: 14. NOC POC Handle: ** OTHER OPTIONAL FIELDS 15. Referral Server: 16. Public Comments: 17. Additional Information: END OF TEMPLATE If you would like assistance completing this template, please do not hesitate to contact ARIN's Registration Services Help Desk at +1 (703) We'll be glad to help you! CUT HERE TEMPLATE INSTRUCTIONS: Please copy and paste the text-based template into the body of an and send to hostmaster@arin.net with the subject line, "ORGANIZATION TEMPLATE". Please ensure your client sends ARIN the message as plain ASCII text, not as HTML. Please do not attach the template. IMPORTANT NOTE: Do not remove or modify the template header, i.e. the line beginning with "Template:" or the footer, i.e. "END OF TEMPLATE". Both are required for processing. 00. An API Key is a string of characters you can use to identify yourself to ARIN. You must first set up an ARIN Online account and create your API Key.
5 If you are modifying or removing an Org ID, your ARIN Online account must be linked to a POC authorized to make the request. Find more information about API Keys at: This template allows you to register a new Org ID, modify information for an existing Org ID or remove an existing Org ID not associated with resources in ARIN's database. This registration action is required. Valid values are: N for New M for Modify R for Remove 02. If you are modifying or removing an existing Org ID, the handle is required for processing. If you are registering a new Org ID in ARIN's Whois database, this field must be blank. If you are unsure of the handle, search for the company's name in ARIN's Whois database. 03. Provide the legal name of the organization as it is registered with local, regional or national authorities. If applicable to future business you conduct with ARIN, ARIN will require any contracts to be signed with this legally registered business name. Org Legal Name cannot be updated. If you are modifying an Org record, this field should be left blank. 04. If applicable, provide the: - fictitious business name - doing business as (D/B/A) name - operating as (O/A) name... of the organization as it is registered with local or regional authorities. This is not a required field. If you provide data for this field, it will replace the Organization's Legal Name for display in ARIN's Whois. If you do not provide data for this field, the data you entered in field 03. will display in ARIN's Whois. Org D/B/A Name cannot be updated. If you are modifying an Org record, this field should be left blank. 05. Provide your organization's business tax ID, as provided to you by national authorities. DO NOT LIST A SOCIAL SECURITY NUMBER OR A SOCIAL INSURANCE NUMBER. In the United States, this field should contain your organization's Federal Employer Identification Number (FEIN). If your organization's FEIN is a Social Security Number, DO NOT FILL OUT THIS FIELD. ARIN does not want to know your SSN! In Canada, this field should contain your Canadian Corporate Number, which is your 9-digit Business Number plus your 6-digit Revenue Account Number. If you are unsure of what data to provide for this question, leave it blank. 06. Indicate the street address for the organization. (If you are
6 updating the street address of an existing Org ID, you must include all address lines.) Although the template provides only two address fields, you may duplicate field 06. as many times as necessary to capture the entire address. 07. Indicate the city of the organization. 08. Indicate the two-letter abbreviation of the state or province of the organization. 09. Provide the postal code of the organization. 10. Provide the ISO-3166 two-character country code of the organization. You can find a complete listing of country codes at: Indicate the ARIN POC handle of the person in the organization responsible for maintaining the Org ID record. If you have not yet registered a POC handle for this person, please submit a POC template. You cannot register a new POC handle with this form. 12. Indicate the ARIN POC handle of a contact responsible for the technical aspects of maintaining your network. If you have not yet registered a POC handle for this person, please submit a POC template. You cannot register a new POC handle with this form. Although the template provides only one Tech POC field, you may duplicate field 12. to list multiple Tech POCs. OPTIONAL FIELDS: 13. Indicate the ARIN POC handle of a contact responsible for handling operational aspects of the acceptable or appropriate uses of the allocated network. The abuse POC may not make modifications to any registration records. If you have not yet registered a POC handle for this person, please submit a POC template. You cannot register a new POC handle with this form. Although the template provides only one Abuse POC field, you may duplicate field 13. to list multiple Abuse POCs. If you are modifying an Org record and would like to remove all Abuse POCs, enter NONE in this field. 14. Indicate the ARIN POC handle for your NOC. The NOC POC may not make modifications to any registration records. If you have not yet registered a POC handle for this person, please submit a POC template. You cannot register a new POC handle with this form. Although the template provides only one NOC POC field, you may duplicate field 12. to list multiple NOC POCs.
7 If you are modifying an Org record and would like to remove all NOC POCs, enter NONE in this field. 15. If your organization runs a publicly-accessible rwhois server, please indicate its hostname and port number. Please enter in the format of: rwhois://hostname:port If you do not run an rwhois server, please leave this field blank. If you are modifying an Org record and would like to remove the rwhois server, enter NONE in this field. 16. If there are any comments that you would like publicly displayed in ARIN's Whois, detail them here. Suggested comments are: Public Comments: Public Comments: Standard NOC hours are 7am to 11pm EST If you are modifying an Org record and would like to remove the public comments, enter NONE in this field. 17. Use this section to provide additional information to ARIN. If you are attaching any supporting documentation to your , please indicate this here. If you are modifying or removing an Org record, this field should be left blank.
8 Template: ARIN-REASSIGN-SIMPLE-5.0 ** As of XXX 2010 ** Detailed instructions are located below the template. 00. API Key: 01. Registration Action (N,M, or R): 02. Network Name: 03. IP Address and Prefix or Range: 04. Origin AS: 05. Private (Yes or No): 06. Customer Name: 07. Customer Address: 07. Customer Address: 08. Customer City: 09. Customer State/Province: 10. Customer Postal Code: 11. Customer Country Code: 12. Public Comments: END OF TEMPLATE If you would like assistance completing this template, please do not hesitate to contact ARIN's Registration Services Help Desk at +1 (703) We'll be glad to help you! CUT HERE TEMPLATE INSTRUCTIONS: Please copy and paste the text-based template into the body of an and send to with the subject line, "REASSIGN SIMPLE". Please ensure your client sends ARIN the message as plain ASCII text, not as HTML. Please do not attach the template. IMPORTANT NOTE: Do not remove or modify the template header, i.e. the line beginning with "Template:" or the footer, i.e. "END OF TEMPLATE". Both are required for processing. 00. An API Key is a string of characters you can use to identify yourself to ARIN. You must first set up an ARIN Online account and create your API Key. Your ARIN Online account must be linked to a POC authorized to make the request. Find more information about API Keys at: This template allows you to register a new simple reassignment,
9 modify information for an existing simple reassignment or remove an existing simple reassignment. This registration action is required. Valid values are: N for New M for Modify R for Remove 02. The network name is used as an identifier. Supply a short name consisting of a combination of up to 50 letters and/or numbers for the network. You may use a dash (-) as part of the network name, but no other special characters, such as periods or underscores. 03. Indicate the network being modified. Valid values are: / List all AS numbers from which the network may originate. You can list as many AS numbers as necessary. You must separate multiple AS numbers with a comma. You may not list AS number ranges; only list individual AS numbers. 05. ARIN's Number Resource Policy Manual (NRPM) allows for residential customer privacy. An organization with residential downstream customers may maintain the privacy of those residential customers as long as accurate Technical and Abuse POCs are visible on the upstream Whois record. By specifying 'Yes' in this field, ARIN's Whois will display 'Private Customer - <Upstream Org Name>' for the customer's name and 'Private Residence' as the customer's street address. By specifying 'No' in this field, the information provided below will be displayed in ARIN's Whois. 06. Provide the legal name of the customer receiving the reassignment as it is registered with local, regional or national authorities. 07. Indicate the street address for the customer receiving the reassignment. Although the template provides only two address fields, you may duplicate field 06. as many times as necessary to capture the entire address. 08. Indicate the city of the customer receiving the reassignment. 09. Indicate the two-letter abbreviation of the state or province of the customer receiving the reassignment. 10. Indicate the postal code of the customer receiving the reassignment. 11. Indicate the ISO-3166 two-character country code of the customer
10 receiving the reassignment. You can find a complete listing of country codes at: If there are any comments you would like publicly displayed in ARIN's Whois, detail them here. If you are modifying a reassigned network and would like to remove the public comments, enter NONE in this field.
CUT HERE
Template: ARIN-IPv6-NET-MOD-5.0 ** As of XXX 2010 ** Detailed instructions are located below the template. 00. API Key: 01. Registration Action (M or R): 02. IPv6 Address and Prefix: 03. Network Name:
More informationDepartment of Finance and Administration Post Office Box 8055
General Information STATE OF ARKANSAS EQUAL OPPORTUNITY EMPLOYER REVENUE DIVISION Individual Income Tax Withholding Branch 7 th and Wolfe Streets, Room 1380 Department of Finance and Administration Post
More informationChange Healthcare CLAIMS Provider Information Form *This form is to ensure accuracy in updating the appropriate account
PAYER ID: SUBMITTER ID: 1 Provider Organization Practice/ Facility Name Change Healthcare CLAIMS Provider Information Form *This form is to ensure accuracy in updating the appropriate account Provider
More informationCORE-required Maximum EFT Enrollment Data Set
CORE-required Maximum EFT Data Set The following table is taken directly from CORE Operating Rule 380 and identifies all details related to the fields contained within this document. Individual Data Element
More informationARIN Policies How to Qualify for Number Resources. Leslie Nobile
ARIN Policies How to Qualify for Number Resources Leslie Nobile Director, Registration Services ARIN Policies IPv4 IPv6 ASN Terms Allocate to issue number resources to ISPs (LIRs) for internal networks
More informationAccounts Receivable Customer
Accounts Receivable Customer Contents Overview... 1 Document Layout... 2 General Information Tab... 3 Corporate Information Tab... 3 Contact Information Tab... 4 Addresses Tab... 4 Overview The Customer
More informationWhois & Data Accuracy Across the RIRs
Whois & Data Accuracy Across the RIRs Terms ISP An Internet Service Provider is allocated address space by an RIR for the purpose of providing connectivity and address space to their downstream customer
More informationPAYER ENROLLMENT INSTRUCTIONS FOR
PAYER ENROLLMENT INSTRUCTIONS FOR Before enrolling please be sure your Revenue Performance Advisor contract includes the transactions you will be using. If you are unsure of the transactions you are contracted
More informationVISITING ANGELS HOME HEALTH CARE, LLC National Provider Identifiers Registry
1710083985 VISITING ANGELS HOME HEALTH CARE, LLC The Administrative Simplification provisions of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) mandated the adoption of standard
More information1304 Vermillion Street Hastings, MN Ph Fax
Page 1 of 1 2/24/2014 NEW MEXICO MEDICAID DENTAL ELECTRONIC REMITTANCE ADVICE (ERA) ENROLLMENT REGISTRATION PAYER ID NUMBERS CKNM1 ELECTRONIC REGISTRATIONS AGREEMENTS REQUIRED CCD+ Reassociation SEND REGISTRATION
More informationSouth Shore Regional School Board. Job Application Guide. For Non-Teaching Positions
South Shore Regional School Board Job Application Guide For Non-Teaching Positions Table of Contents Employment Opportunities Site... 1 Creating a Profile... 3 Completing Your Profile... 4 E-mail Registration
More informationData Type and Format (Not all data elements require a format specification)
Individual Data Element Name (Term) Sub-element Name (Term) Data Element Description Data Type and Format (Not all data elements require a format specification) Data Element Requirement for Health Plan
More informationXRMS Open Source. User Manual v March 2006
XRMS Open Source User Manual v 1.99 28 March 2006 Copyright Information Copyright 2005-2006 XRMS Development Team. Some rights reserved. Licensed under the GNU Free Documentation License [http://www.gnu.org//copyleft/fdl.html].
More informationWERNER ENTERPRISES INC. National Provider Identifiers Registry
1881681997 WERNER ENTERPRISES INC. The Administrative Simplification provisions of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) mandated the adoption of standard unique identifiers
More informationProvider Registration Job Aid. Contents
Provider Registration Job Aid Contents Purpose... 2 Job Aid Organization... 3 Key Terms and Concepts... 4 Roles and Responsibilities... 7 High-Level Overview... 8 Your Tasks... 9 Create Provider Information...10
More information220 Burnham Street South Windsor, CT Vox Fax
NEVADA MEDICAID DENTAL ELECTRONIC REMITTANCE ADVICE (ERA) ENROLLMENT REGISTRATION PAYER ID NUMBER ELECTRONIC REGISTRATIONS AGREEMENTS REQUIRED CKNV1 Participation in Dental Electronic Remittance Advice
More information220 Burnham Street South Windsor, CT Vox Fax
WASHINGTON BLUE CROSS BLUE SHIELD (PREMERA) DENTAL ELECTRONIC REMITTANCE ADVICE (ERA) ENROLLMENT REGISTRATION PAYER ID NUMBER 47570 ELECTRONIC REGISTRATIONS AGREEMENTS REQUIRED CCD+ REASSOCIATION SEND
More informationUNITY FAMILY HEALTHCARE National Provider Identifiers Registry
1780630939 UNITY FAMILY HEALTHCARE National Provider Identifiers Registry The Administrative Simplification provisions of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) mandated
More informationFLORIDA INSTITUTE FOR LONG TERM CARE National Provider Identifiers Registry
1851450514 FLORIDA INSTITUTE FOR LONG TERM CARE National Provider Identifiers Registry The Administrative Simplification provisions of the Health Insurance Portability and Accountability Act of 1996 (HIPAA)
More informationCHERRY HILL ORTHOPEDIC SURGEONS,, P.A. National Provider Identifiers Registry
1932268224 ORTHOPEDIC SURGEONS,, P.A. National Provider Identifiers Registry The Administrative Simplification provisions of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) mandated
More informationNEWCO AMBULATORY SURGERY CENTER, LLP National Provider Identifiers Registry
1629079611 NEWCO AMBULATORY SURGERY CENTER, LLP The Administrative Simplification provisions of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) mandated the adoption of standard
More informationWIND RIVER DENTAL LLC National Provider Identifiers Registry
1336309475 WIND RIVER DENTAL LLC National Provider Identifiers Registry The Administrative Simplification provisions of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) mandated
More informationUWho and CRISP. Mark Kosters VeriSign Labs ARIN IX, April 2002
UWho and CRISP Mark Kosters VeriSign Labs, April 2002 1 Apr-2002 UWhat? Universal Whois Uwho is the name of the work VeriSign has committed to in agreement with ICANN (Appendix W.) Formal public consultations
More information220 Burnham Street South Windsor, CT Vox Fax
220 Burnham Street South Windsor, CT 06074 Vox 888-255-7293 Fax 860-289-0055 DELTA DENTAL OF WISCONSIN DENTAL ELECTRONIC REMITTANCE ADVICE (ERA) ENROLLMENT REGISTRATION PAYER ID NUMBER 39069 SPECIAL NOTES
More informationFINANCE MANAGER. Bidding Manual Finance Manager.
FINANCE MANAGER Bidding Manual 2009 Finance Manager Table of Contents Start Page... 5 Setup Which Files Should Be Completed First?... 7 Item Categories... 8 Unit of Measure... 11 Buildings... 13 Requestors...
More information2777 Stemmons Frwy, Suite 1450 Dallas, TX Fax
Instructions for Electronic Remittance Advice (ERA) Enrollment/Change/Cancellation Page 1 Please use this guide to prepare/complete your Electronic Remittance Advice (ERA) Authorization Agreement Form.
More informationRegistration Statement Form 13(N) Extraprovincial Cooperative Association
Freedom of Information and Protection of Privacy Act (FOIPPA): Personal information provided on this form is collected, used and disclosed under the authority of the FOIPPA and the for the purposes of
More informationMASSACHUSETTS MEDICAID EDI CONTRACT INSTRUCTIONS (SKMA0)
MASSACHUSETTS MEDICAID EDI CONTRACT INSTRUCTIONS (SKMA0) Submit the completed Contract Setup Form to: ABILITY Network, ATTN: Enrollment FAX: 888.837.2232 EMAIL: setup@abilitynetwork.com INSTRUCTIONS Print
More informationC&W Facility Services Inc. Registering in the C&W Facility Services Vendor Management System. Revised January 2016
C&W Facility Services Inc. Registering in the C&W Facility Services Vendor Management System Revised January 2016 1 P a g e Registering in the C&W Facility Services Vendor Management System 1. Log into
More informationFIRST CARE INTEGRATED HEALTH SERVICES, INC. National Provider Identifiers Registry
1679597330 FIRST CARE INTEGRATED HEALTH SERVICES, INC. The Administrative Simplification provisions of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) mandated the adoption of standard
More informationTENET HOSPITALS LIMITED National Provider Identifiers Registry
1215969787 TENET HOSPITALS LIMITED National Provider Identifiers Registry The Administrative Simplification provisions of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) mandated
More informationB.C. LLP Registration Information Form
B.C. LLP Registration Information Form Suite 1103-11871 Horseshoe Way Richmond, British Columbia V7A 5H5 Tel: 604-272-6960 Fax: 604-272-6959 Email: info@incorporate.ca Website: www.incorporate.ca Thank
More informationAdmin Control Panel Overview 4. Organization 5. Interview Questions 6
Table of Contents Admin Control Panel Overview 4 Organization 5 Interview Questions 6 Adding an Interview Question 6 Removing an Interview Question 7 Editing an Interview Question 7 Locations 7 Modifying
More informationHEARTLAND HOSPICE SERVICES LLC National Provider Identifiers Registry
1215981329 HEARTLAND HOSPICE SERVICES LLC National Provider Identifiers Registry The Administrative Simplification provisions of the Health Insurance Portability and Accountability Act of 1996 (HIPAA)
More informationChange Healthcare ERA Provider Information Form *This form is to ensure accuracy in updating the appropriate account
PAYER ID: SUBMITTER ID: 1 Provider Organization Practice/ Facility Name Change Healthcare ERA Provider Information Form *This form is to ensure accuracy in updating the appropriate account Provider Name
More informationStatus and Solutions for Whois Data Accuracy. Leslie Nobile, ARIN Tina Morris, ARIN Advisory Council
Status and Solutions for Whois Data Accuracy Leslie Nobile, ARIN Tina Morris, ARIN Advisory Council About ARIN One of 5 Regional Internet Registries (RIRs) Nonprofit corporation based in Chantilly, VA
More informationAETNA BETTER HEALTH OF ILLINOIS 333 W. Wacker Drive Suite 2100, MC F646 Chicago, IL Fax
Instructions for Electronic Remittance Advice (ERA) Enrollment/Change/Cancellation Page 1 Please use this guide to prepare/complete your Electronic Remittance Advice (ERA) Authorization Agreement Form.
More informationChange Healthcare ERA Provider Information Form *This form is to ensure accuracy in updating the appropriate account
PAYER ID: SUBMITTER ID: 1 Provider Organization Practice/ Facility Name Change Healthcare ERA Provider Information Form *This form is to ensure accuracy in updating the appropriate account Provider Name
More informationWHOIS Accuracy Reporting: Phase 1
WHOIS Accuracy Reporting: Phase 1 System Validation Criteria 01 June 2015 Contents WHOIS ARS Background... 3 Project Approach... 3 Validation Criteria... 4 Email Addresses... 5 Email Address: Stage One...
More informationHow to query general person information. Last Updated: 22-Nov-2010
How to query general person information Table of Contents How to view, modify or create a person...3 How to view and modify existing records...4 How to create a new person record...5 How to view, add and
More informationTHE NEW YORK AND PRESBYTERIAN HOSPITAL National Provider Identifiers Registry
1770502635 THE NEW YORK AND PRESBYTERIAN HOSPITAL National Provider Identifiers Registry The Administrative Simplification provisions of the Health Insurance Portability and Accountability Act of 1996
More informationINTRONA CORPORATION National Provider Identifiers Registry
1114217817 INTRONA CORPORATION The Administrative Simplification provisions of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) mandated the adoption of standard unique identifiers
More informationAETNA BETTER HEALTH OF LOUISIANA 2400 Veterans Memorial Blvd., Suite 200 Kenner, LA Fax
Instructions for Electronic Remittance Advice (ERA) Enrollment/Change/Cancellation Page 1 Please use this guide to prepare/complete your Electronic Remittance Advice (ERA) Authorization Agreement Form.
More informationTHE MCGREGOR FOUNDATION National Provider Identifiers Registry
1003884594 THE MCGREGOR FOUNDATION National Provider Identifiers Registry The Administrative Simplification provisions of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) mandated
More informationINSTRUCTIONS for Form I-765
INSTRUCTIONS for Form I-765 General Guidelines Use the most current version of the I-765 form, available at https://www.uscis.gov/i-765. Please type your responses on the I-765 form and print the completed
More informationChange Healthcare ERA Provider Information Form *This form is to ensure accuracy in updating the appropriate account
PAYER ID: SUBMITTER ID: 1 Provider Organization Practice/ Facility Name Change Healthcare ERA Provider Information Form *This form is to ensure accuracy in updating the appropriate account Provider Name
More informationSALDIVAR COASTAL SERVICES, INC. National Provider Identifiers Registry
1508130691 SALDIVAR COASTAL SERVICES, INC. National Provider Identifiers Registry The Administrative Simplification provisions of the Health Insurance Portability and Accountability Act of 1996 (HIPAA)
More informationCHATEAU DE NOTRE DAME National Provider Identifiers Registry
1346721255 CHATEAU DE NOTRE DAME National Provider Identifiers Registry The Administrative Simplification provisions of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) mandated
More informationSupporting Notes for the European IP Address Space Request Form
Supporting Notes for the European IP Address Space Request Form Paula Caslav Mirjam Kuehne Carol Orange Document ID: ripe-220 Date: 4 May, 2001 Obsoletes: ripe-128, ripe-137, ripe-138, ripe-142 See also:
More informationCreating a Hire eform for Academic Staff
UNIVERSITY OF ALBERTA PeopleSoft HCM Creating a Hire eform for Academic Staff Prepared by: HR Operations Created on 8/30/2017 2:49:00 PM Copyright 2017 University of Alberta All rights reserved. The information
More informationDR PAUL J ARNOLD DO National Provider Identifiers Registry
1023206984 DR PAUL J ARNOLD DO National Provider Identifiers Registry The Administrative Simplification provisions of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) mandated the
More informationVETERANS ADMINISTRATION MEDICAL CENTER National Provider Identifiers Registry
1205144730 VETERANS ADMINISTRATION MEDICAL CENTER National Provider Identifiers Registry The Administrative Simplification provisions of the Health Insurance Portability and Accountability Act of 1996
More informationLA JOLLA ORTHOPAEDIC SURGERY CENTER LP National Provider Identifiers Registry
1972503233 LA JOLLA ORTHOPAEDIC SURGERY CENTER LP The Administrative Simplification provisions of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) mandated the adoption of standard
More informationHIN Request Submission Guidelines
HIN Requests Using the HIN-Request Submission Template in a.csv Format or Fixed-Length Text File The accepted layout for HIN requests is as follows: O = Optional, M = Mandatory Field Name Length Begin
More informationPOLK COUNTY BOARD OF COUNTY COMMISSIONERS National Provider Identifiers Registry
1548296338 POLK COUNTY BOARD OF COUNTY COMMISSIONERS National Provider Identifiers Registry The Administrative Simplification provisions of the Health Insurance Portability and Accountability Act of 1996
More informationCAPE COD ENDODONTICS PC National Provider Identifiers Registry
1215016043 CAPE COD ENDODONTICS PC National Provider Identifiers Registry The Administrative Simplification provisions of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) mandated
More information220 Burnham Street South Windsor, CT Vox Fax
NEBRASKA MEDICAID DENTAL ELECTRONIC REMITTANCE ADVICE (ERA) ENROLLMENT REGISTRATION PAYER ID NUMBER SPECIAL NOTES CKNE1 Paper Remittance Advice Statements and Refund Request Reports statements will cease
More informationSICK KIDS (NEED) INVOLVED PEOPLE OF NEW YORK National Provider Identifiers Registry
1669528709 SICK KIDS (NEED) INVOLVED PEOPLE OF NEW YORK National Provider Identifiers Registry The Administrative Simplification provisions of the Health Insurance Portability and Accountability Act of
More informationFEDERAL BUREAU OF PRISONS National Provider Identifiers Registry
1275884165 FEDERAL BUREAU OF PRISONS National Provider Identifiers Registry The Administrative Simplification provisions of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) mandated
More informationVWELL WEST, INC. National Provider Identifiers Registry
1639333016 VWELL WEST, INC. The Administrative Simplification provisions of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) mandated the adoption of standard unique identifiers
More informationMILESTONES SPEECH AND LAUGUAGE SERVICES National Provider Identifiers Registry
1568528263 MILESTONES SPEECH AND LAUGUAGE SERVICES National Provider Identifiers Registry The Administrative Simplification provisions of the Health Insurance Portability and Accountability Act of 1996
More informationHUNTINGTON PARK MISSION MEDICAL GROUP National Provider Identifiers Registry
1609998848 HUNTINGTON PARK MISSION MEDICAL GROUP The Administrative Simplification provisions of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) mandated the adoption of standard
More informationFARMACIA BORIKEN National Provider Identifiers Registry
1740336593 FARMACIA BORIKEN National Provider Identifiers Registry The Administrative Simplification provisions of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) mandated the adoption
More informationMANOR CARE OF BETHLEHEM PA (2029) LLC National Provider Identifiers Registry
1740235613 MANOR CARE OF BETHLEHEM PA (2029) LLC National Provider Identifiers Registry The Administrative Simplification provisions of the Health Insurance Portability and Accountability Act of 1996 (HIPAA)
More informationWorker s Compensation Board of Indiana (IN WCB) EDI Claims Release 3.1 Trading Partner Profile Registration Instructions
Worker s Compensation Board of Indiana (IN WCB) EDI Claims Release 3.1 Trading Partner Profile Registration Instructions Revised Date: 7/16/2018 Table of Contents Table of Contents... 2 Overview:... 3
More informationPaymentWorks Form Guide. Non US Individual Setup with Electronic Payment
PaymentWorks Form Guide Non US Individual Setup with Electronic Payment 7 February 2019 Welcome! A request has been made to add you as a vendor within the Johns Hopkins System. The instructions in this
More information4350 E. Cotton Center Boulevard Building D Phoenix, AZ / Fax
Instructions for Electronic Remittance Advice (ERA) Enrollment/Change/Cancellation Page 1 Please use this guide to prepare/complete your Electronic Remittance Advice (ERA) Authorization Agreement Form.
More informationMunicipal Bond Payment Reporting Information Annual Information Reporting Requirement for Payers and Transmitters
www.revenue.state.mn.us Municipal Bond Payment Reporting Information Annual Information Reporting Requirement for Payers and Transmitters Income Tax Fact Sheet 19 19 Fact Sheet This fact sheet explains
More informationWESTSIDE PEDIATRICS,P.A. National Provider Identifiers Registry
1881756922 WESTSIDE PEDIATRICS,P.A. The Administrative Simplification provisions of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) mandated the adoption of standard unique identifiers
More information220 Burnham Street South Windsor, CT Vox Fax
NEW HAMPSHIRE MEDICAID DENTAL ELECTRONIC REMITTANCE ADVICE (ERA) ENROLLMENT REGISTRATION PAYER ID NUMBER SPECIAL NOTES CKNH1 ERAs can only be sent to one Trading Partner, if a provider has previously requested
More informationTMC PROVIDER GROUP PLLC National Provider Identifiers Registry
1285099085 TMC PROVIDER GROUP PLLC National Provider Identifiers Registry The Administrative Simplification provisions of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) mandated
More informationVHS ACQUISITION SUBSIDIARY NUMBER 9 INC National Provider Identifiers Registry
1740252592 VHS ACQUISITION SUBSIDIARY NUMBER 9 INC National Provider Identifiers Registry The Administrative Simplification provisions of the Health Insurance Portability and Accountability Act of 1996
More informationUNIVERSITY OF ALABAMA AT BIRMINGHAM National Provider Identifiers Registry
1235237900 UNIVERSITY OF ALABAMA AT BIRMINGHAM National Provider Identifiers Registry The Administrative Simplification provisions of the Health Insurance Portability and Accountability Act of 1996 (HIPAA)
More informationINDIANA UNIVERSITY HEALTH PAOLI INC National Provider Identifiers Registry
1912984451 INDIANA UNIVERSITY HEALTH PAOLI INC The Administrative Simplification provisions of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) mandated the adoption of standard
More information220 Burnham Street South Windsor, CT Vox Fax
220 Burnham Street South Windsor, CT 06074 Vox 888-255-7293 Fax 860-289-0055 KANSAS MEDICAID DENTAL ELECTRONIC REMITTANCE ADVICE (ERA) ENROLLMENT REGISTRATION PAYER ID NUMBER CKKS1 SPECIAL NOTES 1. Upon
More informationSOVEREIGN HEALTHCARE OF ST. AUGUSTINE, LLC National Provider Identifiers Registry
1538156195 SOVEREIGN HEALTHCARE OF ST. AUGUSTINE, LLC National Provider Identifiers Registry The Administrative Simplification provisions of the Health Insurance Portability and Accountability Act of 1996
More informationRENTON SCHOOL DISTRICT National Provider Identifiers Registry
1396830436 RENTON SCHOOL DISTRICT The Administrative Simplification provisions of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) mandated the adoption of standard unique identifiers
More informationBAYONNE BOARD OF EDUCATION National Provider Identifiers Registry
1174735096 BAYONNE BOARD OF EDUCATION National Provider Identifiers Registry The Administrative Simplification provisions of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) mandated
More informationChange Healthcare ERA Provider Information Form *This form is to ensure accuracy in updating the appropriate account
PAYER ID: SUBMITTER ID: 1 Provider Organization Practice/ Facility Name Change Healthcare ERA Provider Information Form *This form is to ensure accuracy in updating the appropriate account Provider Name
More informationEDI Electronic Funds Transfer (EFT) and Electronic Remittance Advice (ERA) Online Enrollment Instructions
Welcome to the instructions for online enrollment for your EFA and EFT. Please follow the instructions below to improve your experience in enrolling and receiving your electronic transactions. If at any
More informationSELF MEDICAL GROUP National Provider Identifiers Registry
1073840856 SELF MEDICAL GROUP National Provider Identifiers Registry The Administrative Simplification provisions of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) mandated the
More informationAuthorization Agreement
Authorization Agreement For Electronic Health Care Claim Payment / Advice 835 Thank you for your interest in the Electronic Health Care Claim Payment/Advice (835), also known as Electronic Remittance Advice
More informationCREEDE CHIROPRACTIC AND KINESIOLOGY CLINIC, INC National Provider Identifiers Registry
1760519409 CREEDE CHIROPRACTIC AND KINESIOLOGY CLINIC, INC National Provider Identifiers Registry The Administrative Simplification provisions of the Health Insurance Portability and Accountability Act
More informationWIND RIVER PAIN MANAGEMENT, LLC National Provider Identifiers Registry
1104992296 WIND RIVER PAIN MANAGEMENT, LLC National Provider Identifiers Registry The Administrative Simplification provisions of the Health Insurance Portability and Accountability Act of 1996 (HIPAA)
More informationNEWYORK-PRESBYTERIAN-QUEENS National Provider Identifiers Registry
1952347205 NEWYORK-PRESBYTERIAN-QUEENS National Provider Identifiers Registry The Administrative Simplification provisions of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) mandated
More informationEXCELLENCE HOME HEALTH CARE AGENCY, INC. National Provider Identifiers Registry
1568556801 EXCELLENCE HOME HEALTH CARE AGENCY, INC. National Provider Identifiers Registry The Administrative Simplification provisions of the Health Insurance Portability and Accountability Act of 1996
More informationKAISER PERMANENTE National Provider Identifiers Registry
1992711022 KAISER PERMANENTE National Provider Identifiers Registry The Administrative Simplification provisions of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) mandated the
More informationAn ARIN Update. Susan Hamlin Director of Communications and Member Services
An ARIN Update Susan Hamlin Director of Communications and Member Services ARIN, a nonprofit member-based organization, supports the operation of the Internet through the management of Internet number
More informationMinistry of Transportation
Registry, Appraisal & Qualification SYSTEM (RAQS) REGISTRATION FOR CONSULTANTS A. Introduction The s Registry, Appraisal, & Qualification System (RAQS) is an electronic web- based system used to register,
More informationAETNA BETTER HEALTH OF OHIO 7400 W. Campus Rd. New Albany, OH Fax
Instructions for Electronic Remittance Advice (ERA) Enrollment/Change/Cancellation Page 1 Please use this guide to prepare/complete your Electronic Remittance Advice (ERA) Authorization Agreement Form.
More informationProposed Interim Model for GDPR Compliance-- Summary Description
Proposed Interim Model for GDPR Compliance-- Summary Description (The Calzone Model, 28 February 2018) Prepared by: ICANN Org I. Introduction The Proposed Interim Model balances competing elements of models
More informationNANP Administration System (NAS) User Registration Guide 2.6v
NANP Administration System (NAS) User Registration Guide 2.6v November 8, 2017 TABLE OF CONTENTS 1.0 Introduction... 4 1.1 Purpose... 4 1.2 NAS Overview... 4 1.3 Content Summary... 4 1.4 Problem Solving...
More informationIndustrial Radiography (Category B) Diagnostic X-Ray Equipment Facility RI General Law Chapter RAD
Application for Registration and Instructions for Industrial Radiography (Category B) Diagnostic X-Ray Equipment Facility RI General Law Chapter 23-1.3-RAD Registrant Registration Number: Reason for application
More information220 Burnham Street South Windsor, CT Vox Fax
DELTA DENTAL OF ILLINOIS GROUP PLANS DENTAL ELECTRONIC REMITTANCE ADVICE (ERA) ENROLLMENT REGISTRATION PAYER ID NUMBER 05030 SPECIAL NOTES Participation with Direct Deposit (EFT) is required for receipt
More informationPUERTO RICO CHILDREN'S HOSPITAL,INC. National Provider Identifiers Registry
1992988802 PUERTO RICO CHILDREN'S HOSPITAL,INC. National Provider Identifiers Registry The Administrative Simplification provisions of the Health Insurance Portability and Accountability Act of 1996 (HIPAA)
More informationWILLISTON RESCUE SQUAD National Provider Identifiers Registry
1023062544 WILLISTON RESCUE SQUAD The Administrative Simplification provisions of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) mandated the adoption of standard unique identifiers
More informationFirst access Minnesota State Employee Home by logging in with your Star ID and password, you will land on the Employee Home screen.
Introduction provides the ability to search for a SWIFT vendor on the web using several different search criteria options such as the vendor s legal (location) name, Doing Business As (DBA) name, location
More informationDIEGO G ALLENDE A MEDICAL CORPORATION National Provider Identifiers Registry
1033266184 DIEGO G ALLENDE A MEDICAL CORPORATION National Provider Identifiers Registry The Administrative Simplification provisions of the Health Insurance Portability and Accountability Act of 1996 (HIPAA)
More informationLABORATORIO CLINICO MONROIG National Provider Identifiers Registry
1326106535 LABORATORIO CLINICO MONROIG National Provider Identifiers Registry The Administrative Simplification provisions of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) mandated
More informationVENI-EXPRESS, INC. National Provider Identifiers Registry
1255696175 VENI-EXPRESS, INC. The Administrative Simplification provisions of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) mandated the adoption of standard unique identifiers
More information