Let’s work together!
MVP’s network of providers includes more than 50,000 different medical and behavioral health professionals and facilities. Join us in helping bring better care to the communities we serve.
For more information, see our credentialing details and frequently asked questions.
Note: You can also review how to join the network in MVP Health Care’s Provider Participation Guide, under Provider Demographic Change Forms below.
Provider Demographic Change Forms
- Provider Application Request — To properly use the Provider Application Request Form, please right-click the link and select “Save link as” to save the file to your device. Then the form can be populated in Acrobat Reader. This should NOT be filled in from your browser.
- Using the Provider Change of Information Form (PDF)
- Provider Change of Information Form (Submit Online)
- Facility/Ancillary Provider Change of Information (PDF)
- Provider Participation Guide (PDF)
- Supplemental Provider Credentialing Application (PDF)
- MVP Contracted Hospitals (PDF)
- Practitioner Continuity of Care Statement (PDF)
- Provider Leave of Absence Notification (PDF)
- Provider Credentialing Rights (PDF)
- Federal Tax W-9 (PDF)
Professional Relations Disclosures
- Code of Ethics and Business Conduct Summary (PDF)
- Corporate Code of Ethics and Business Conduct (PDF)
- Detecting and Preventing Fraud, Waste and Abuse (PDF)
- Harmonious Health Care Plan FAQs (PDF)
- Independent Dispute Resolution Process for Emergency and Surprise Bills—Health Care Providers (PDF)
- NPI Information