New National Practitioner Data Bank (NPDB) Query and Credentialing Committee

Effective Oct. 1, 2025, in order to align with National Committee for Quality Assurance (NCQA) standards, General Dynamics Information Technology (GDIT) will begin conducting queries through the National Practitioner Data Bank (NPDB) for individual providers.

NPDB queries will apply to all providers enrolling with: NC Medicaid, Division of Mental Health, Developmental Disabilities and Substance Use Services (DMHDDSUS), Division of Public Health (DPH), Office of Rural Health (ORH). 

A Credentialing Committee will also be established to determine eligibility for provider participation. This committee will be responsible for reviewing individual and organization provider files that contain adverse items for disposition of their enrollment, reenrollment and re-credentialing applications as well as issues discovered through ongoing monitoring.

Stakeholders are encouraged to stay engaged through NC Medicaid’s ongoing webinar series and regular review of the Credentialing Committee webpage. For questions or comments about this initiative, please email medicaid.credcommittee.stakeholders@dhhs.nc.gov. 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

25212-R-2817