The ID of the rendering provider covered by the credentialing span.
The ID of the practice location at which the rendering provider is covered by the credentialing span.
The ID of the payer covered by the credentialing span.
The states covered by the credentialing span. A span may be national and cover all states.
Start date of the credentialing span.
End date of the credentialing span.
Date that the credential paperwork was submitted.
Date that the payer loaded the credentialing span into their system.
The rendering provider covered by the credentialing span.
The practice location at which the rendering provider is covered by the credentialing span.
The payer doing the credentialing.
The states covered by the credentialing span. A span may be national and cover all states.
Status of the credentialing span.
Source of the credentialing span.
Is the credentialing span enabled?
Start date of the credentialing span.
End date of the credentialing span.
Date that the credential paperwork was submitted.
Date that the payer loaded the credentialing span into their system.
Provider ID for the related medallion payer enrollment.