Add an Additional Location

MHS asks that additional addresses only be requested for practitioners that display on the directory. Additional address are utilized for directory purposes only and are not needed for claims payment. For more information on addresses and practitioner enrollment please refer to Chapter 17 of the MHS Provider Manual (PDF).

MHS will not process additional address requests for these practitioner types: Emergency Medicine, Radiology, Anesthesiology (excluding Pain Management), Pathology, CRNA, Midwives, Occupational Therapy, Mid-levels not acting as a PCP holding a panel, and Practitioners who practice exclusively in a facility setting.

If multiple practitioners are adding this address as an additional location, please attach a spreadsheet with their names and NPI numbers.

Additional Location Address

Update Requested By: