Enrolling with the Student Health Care taxonomy code (390200000X)

Per Federal guidelines, applicants must meet all program requirements and qualifications for which they are seeking enrollment before they can be enrolled with NC Medicaid. Specific qualifications for each provider type are listed in the Provider Permission Matrix which can be found on the NCTracks Enrollment webpage under Quick Links. The taxonomy code, license and license type must match and meet all program requirements.

During enrollment with NCTracks, the Student Health Care taxonomy code (390200000X) is only allowed for residents or interns who do not have a full medical or dental license. If this taxonomy is selected and it is determined that the applicant holds a full medical or dental license, the application will be denied.

Prior to submitting an application with a Student Health Care taxonomy code (390200000X), it is imperative that applicants confirm with the licensing board which type of license the provider currently holds.

Verify license for NC dental providers:

http://www.ncdentalboard.org/

Verify license for NC medical providers:

https://www.ncmedboard.org/

If the provider has a medical or dental license:

All providers with a full medical or dental license must submit a provider enrollment application with their current license and taxonomy code. If the Student Health Care taxonomy code (390200000X) is submitted and it is confirmed that the provider has a “full” medical or dental license, the application will be denied. The provider must then resubmit the application with the correct information and pay all appropriate application fees for the resubmission.

If the provider has a resident or intern license:

All resident and intern providers licensed through the Medical or Dental Board with a Resident Training License (RTL) who are enrolling with NCTracks must enroll as an Ordering, Prescribing and Referring (OPR) lite provider via the abbreviated application in the secure NCTracks provider portal. When enrolling as an OPR lite provider, these practitioners must use the taxonomy 390200000X for Student Health Care and enter “RTL” in the license number field.

Correcting or updating the Student Health Care taxonomy code:

If the provider is currently enrolled with a Student Health Care taxonomy code and has subsequently obtained a full medical or dental license, a Manage Change Request (MCR) must be submitted to upgrade the provider from an OPR lite provider to a fully enrolled provider (the $100 application fee will be required). The MCR should include the following revisions:

  1. Add the correct taxonomy code with the effective date of the medical or dental license to each applicable location.
  2. End date the RTL taxonomy code with the begin date of the full medical or dental taxonomy code.
  3. Add the full license information on the accreditation page to each applicable location.