Updated as of July 23, 2020 Details on New Information Required on Applications for Individual Providers

It was previously announced that effective Aug. 9, 2020, NCTracks will store, capture and validate the following:

  • Work history as a health professional (past five years, if more than six month gap, explanation of gap)
  • Malpractice insurance (coverage type and amount)
  • Highest level of education

Additional information providers should note:

  • If additional information is required for the processing of the application, the application will be in a “returned” status and the provider will be contacted. The Upload Documents page will allow the provider to upload supporting documentation (such as copies of certifications) if necessary.
  • Providers should NOT upload school transcripts on the Upload Documents page. If applicable, the provider will receive an email with instructions on where to send the documentation.
  • When entering their work history, if the enrolling provider is currently a resident or intern, he/she should enter the details of that residency/internship such as:

Job Title: Resident

Company Name: Healthcare Facility XYZ

Start Date:  Date residency/internship began

End Date: 12/31/9999 if still a resident/intern

  • In addition to entering required certifications, individual providers are now requested to add all board certifications. Enrollment, re-enrollment and Manage Change Request (MCR) applications will still inform the provider with specific text of what certifications are required for the taxonomy entered on the application.


Please see the chart below with further details on application requirements and supporting documentation that may be required:

New Supplemental Data on Provider Application

This information is ONLY applicable to individual providers submitting an initial, re-enrollment or re-verification application. 


Supplemental Information




Data Fields


Supporting Documentation

Work History

- Provider must enter the past five years of health related work history


- Provider must provide explanation of any gaps of six months or more in writing


Verification: None required

- Company Name

- Job Title

- Start Date

- End Date


Notes: If the job is still current, enter 12/31/9999.

If the enrolling provider is a resident/intern, enter Resident as the job title.

Written documentation explaining any gaps of six months or more in healthcare-related work history that occurred in the past five years must be uploaded.


- Provider must enter his highest level of education completed


Verification: GDIT will source verify using LexisNexis (LN)

- School Name

- Degree

- Start Date

- Graduation Date

If unable to source verify using LN, the application will be returned to provider to obtain an official transcript.  This transcript can be a SEALED certified transcript mailed to NCTracks or an electronic copy sent directly from the school.

Mailing Address: 

Provider Enrollment

PO Box 300009

Raleigh, NC 27622


The email address will be provided in the Request for Additional Information if needed.

Board Certifications (including DEA)

- In addition to certifications required for a taxonomy code, individual providers are now requested to add all board certifications

- Providers will have the ability to add additional board certifications in reverification applications


Verification: GDIT will source verify using LexisNexis (LN)

No new fields






If unable to source verify, the application will be returned to the provider to upload certification documentation.


Malpractice Insurance Coverage

-Provider answers ”yes”/”no” to whether  they currently have malpractice insurance coverage


Verification: None required

Must provide:

- Malpractice Type

- Insurance Agency     Name

- Amount

- Effective Date

- Expiration Date