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Annual Save 17%

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Country *

Practice name *

Specialty *

Province *

City *

Canadian Registration

CRA Business Number (BN) (optional)

9-digit number issued by the CRA.

GST/HST Number (optional)

BN + RT0001. Required if GST/HST registered.

Provincial Registration # (optional)

Provincial business registration number.

Regulatory College (optional)

US Registration

EIN (Employer ID Number) (optional)

XX-XXXXXXX format. Required for group practices.

Group NPI (Type 2) (optional)

10-digit National Provider Identifier for the practice.

Medicare/Medicaid Enrolled?

State License Board

UK Registration

Companies House Number (optional)

8-digit number from Companies House.

VAT Number (optional)

GB + 9 digits. Required if VAT registered.

CQC Registration # (optional)

Care Quality Commission registration.

ICO Registration # (optional)

Information Commissioner's Office (data protection).

Australian Registration

ABN (optional)

11-digit Australian Business Number.

ACN (optional)

9-digit Australian Company Number (if incorporated).

Medicare Provider Location Number (optional)

Required for Medicare billing.

First name *

Last name *

Title / Designation *

Work email *

Password *

Minimum 8 characters

Confirm password *

Canadian Provider Credentials

College Registration # (optional)

Your provincial medical college registration number.

Billing Provider # (optional)

Provincial billing number (OHIP, MSP, AHCIP etc).

US Provider Credentials

Individual NPI (Type 1) (optional)

10-digit individual National Provider Identifier.

DEA Number (optional)

Required if you prescribe controlled substances.

State Medical License # (optional)

License Expiry Date (optional)

UK Provider Credentials

GMC Number (optional)

7-digit General Medical Council registration.

NMC PIN (optional)

Nursing and Midwifery Council PIN.

GDC Number (optional)

General Dental Council registration.

HCPC Registration # (optional)

Health & Care Professions Council.

Australian Provider Credentials

AHPRA Registration # (optional)

Australian Health Practitioner Regulation Agency.

Medicare Provider # (optional)

Required for Medicare billing.

Prescriber Number (optional)

Required if you prescribe PBS medications.