Rule 23-213-3.1 - Provider Enrollment Requirements Providers of speech-language pathology must comply with the requirements set forth in Part 200, Rule 4.8 in addition the provider type specific requirements outlined below. Therapy providers wishing to enroll as group providers must adhere to the enrollment requirements in Part 200, Rule 4.9.
A. National Provider Identifier (NPI), verification from National Plan and Provider Enumeration System (NPPES). B. Copy of current licensure card or permit. C. Documentation that the individual meets one (1) of the following requirements: 1. Has a certificate of clinical competence from the American Speech and Hearing Association (ASHA), 2. Has completed the equivalent educational requirements and work experience necessary for the certificate, or 3. Has completed the academic program and is acquiring supervised work experience to qualify for the certificate. D. Verification of social security number using a social security card, driver's license if it notes the social security number, military ID or a notarized statement signed by the provider noting the social security number. The name noted on verification must match the name noted on the W-9. 23 Miss. Code. R. 213-3.1
42 C.F.R. § 440.110; 42 C.F.R. 455, Subpart E; Miss. Code Ann. § 43-13-121.