> ## Documentation Index
> Fetch the complete documentation index at: https://docs.rcintell.com/llms.txt
> Use this file to discover all available pages before exploring further.

# NPI Lookup

> Search for any provider or organization by NPI, name, taxonomy, or location — enriched with RCI billing knowledge

> Paste an NPI. Get the provider and the billing context. Free.

The NPI Lookup is RCI's public tool for searching the NPPES National Provider Identifier registry — enriched with RCI's knowledge layer. Find a provider, see their taxonomy, address, and organization — then resolve the billing context for their facility.

**Try it at [rcintell.com/tools](https://rcintell.com/tools)**

## How it works

**Search by NPI number:**

```
NPI: 1234567890

┌──────────────────────────────────────────────────────────────┐
│  Provider: Jane Smith, MD                                     │
│  NPI: 1234567890                                              │
│  Type: Individual (NPI-1)                                     │
│  Status: Active                                               │
│                                                               │
│  Taxonomy:                                                    │
│  ├─ 207R00000X — Internal Medicine                            │
│  └─ Primary taxonomy                                         │
│                                                               │
│  Practice Address:                                            │
│  ├─ 123 Medical Center Dr                                     │
│  ├─ Topeka, KS 66604                                          │
│  └─ Phone: (785) 555-0100                                    │
│                                                               │
│  Organization:                                                │
│  ├─ Stormont Vail Health                                      │
│  └─ CCN: 170001                                               │
│                                                               │
│  ─── RCI ENRICHMENT ──────────────────────────────────        │
│                                                               │
│  Billing Context (via CCN 170001):                            │
│  ├─ MAC: Jurisdiction 5 (WPS)                                │
│  ├─ GPCI: Work 1.000 | PE 0.891 | MP 0.407                  │
│  ├─ Payment System: OPPS / IPPS / MPFS                       │
│  ├─ Billing Form: CMS-1500 (prof) / UB-04 (inst)            │
│  ├─ Timely Filing (Medicare): 12 months                      │
│  └─ State Medicaid: KanCare                                  │
│                                                               │
└──────────────────────────────────────────────────────────────┘
```

**Or search by name, organization, taxonomy, city, or state:**

| Search by         | Example                          |
| ----------------- | -------------------------------- |
| NPI number        | `1234567890`                     |
| Provider name     | `Jane Smith`                     |
| Organization name | `Stormont Vail`                  |
| Taxonomy code     | `207R00000X` (Internal Medicine) |
| City + State      | `Topeka, KS`                     |
| State only        | `KS`                             |

## What makes this different from NPPES

The [NPPES NPI Registry](https://npiregistry.cms.hhs.gov/) gives you the provider record. RCI gives you the provider record **plus the billing context**:

| NPPES gives you          | RCI adds                         |
| ------------------------ | -------------------------------- |
| Provider name, NPI, type | Facility CCN linkage             |
| Practice address         | GPCI values for that location    |
| Taxonomy code            | MAC jurisdiction                 |
| Organization affiliation | Payment system (OPPS/IPPS/MPFS)  |
| Enumeration date         | Billing form (CMS-1500 vs UB-04) |
|                          | Timely filing deadlines          |
|                          | State Medicaid program           |
|                          | Full L1-L6 resolution (with CPT) |

## Use cases

| Who               | Why                                                                                              |
| ----------------- | ------------------------------------------------------------------------------------------------ |
| **Billers**       | Look up a referring provider's NPI, confirm taxonomy, get the billing context for their facility |
| **Credentialing** | Verify NPI status, check taxonomy against specialty                                              |
| **Payers**        | Validate provider identity and facility billing rules during adjudication                        |
| **Revenue cycle** | Cross-reference NPI → CCN → payment rules for claim routing                                      |
| **Platforms**     | Build provider search + billing context into your product                                        |

## Powered by NPPES API

RCI wraps the [CMS NPPES API v2.1](https://npiregistry.cms.hhs.gov/api/?version=2.1) with RCI's knowledge layer enrichment. The underlying NPPES data is public and free. RCI adds the billing intelligence.

## API access

```bash theme={null}
# Search by NPI number
curl "https://api-dev.rcintell.com/v1/providers/npi/1234567890" \
  -H "X-API-Key: kp_test_..."

# Search by name
curl "https://api-dev.rcintell.com/v1/providers/search?last_name=Smith&first_name=Jane&state=KS" \
  -H "X-API-Key: kp_test_..."

# Search by organization
curl "https://api-dev.rcintell.com/v1/providers/search?organization_name=Stormont+Vail&state=KS" \
  -H "X-API-Key: kp_test_..."

# Search by taxonomy
curl "https://api-dev.rcintell.com/v1/providers/search?taxonomy=207R00000X&city=Topeka&state=KS" \
  -H "X-API-Key: kp_test_..."

# NPI lookup with full L1-L6 enrichment
curl "https://api-dev.rcintell.com/v1/providers/npi/1234567890?enrich=true&cpt=99213" \
  -H "X-API-Key: kp_test_..."
```

### Response

```json theme={null}
{
  "npi": "1234567890",
  "type": "NPI-1",
  "provider": {
    "first_name": "Jane",
    "last_name": "Smith",
    "credential": "MD",
    "gender": "F",
    "sole_proprietor": false
  },
  "taxonomies": [
    {
      "code": "207R00000X",
      "desc": "Internal Medicine",
      "primary": true
    }
  ],
  "addresses": {
    "practice": {
      "address_1": "123 Medical Center Dr",
      "city": "Topeka",
      "state": "KS",
      "postal_code": "66604",
      "phone": "7855550100"
    }
  },
  "organization": "Stormont Vail Health",
  "enrichment": {
    "ccn": "170001",
    "gpci": { "work": 1.000, "pe": 0.891, "mp": 0.407 },
    "mac": "Jurisdiction 5 (WPS)",
    "payment_system": "OPPS / IPPS / MPFS",
    "billing_form": "CMS-1500 / UB-04",
    "medicaid_program": "KanCare"
  }
}
```

## Free to use

The NPI Lookup is free at [rcintell.com/tools](https://rcintell.com/tools). Basic lookups require no account. API access with enrichment requires a free API key.