Diversity Information Page 15
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266. Continue to the next page to complete demographic information. The contact information
you enter will be public.
If you are applying as a resident, we strongly advise that you use the address and phone
number for HFH in #8 (below), to protect your privacy.
If you are applying as a student, we strongly advise that you change your contact
information to the HFH address below as soon as possible, to protect your privacy.
7. When asked if you are a sole proprietor state “No.”
8. The domestic mailing address and domestic practice location for a Henry Ford Hospital
House Officer is: Henry Ford Hospital, Medical Education Department
2799 W. Grand Boulevard, Detroit, Michigan 48202‐2608; Phone Number: 313‐916‐2600
9. If you have other National identifiers such as a UPN, Medicare or Medicaid number, please
add on this page.
10. The next page will ask your taxonomy and license info.
If you are applying as a resident, your taxonomy is code 20. You will then be asked to
identify your specialty and to add your license number.
If you are applying as a student, the title on the NPI application will state “Student in an
organized health care education/training program” and your taxonomy code is 39. You can
leave the License Number blank, but you will need your Social Security Number. Once you
start residency, provide your license number and change the contact information to Henry
Ford Hospital (see #8 above), to protect your privacy, as the site is public.
11. The license number they are asking for is your Medical License, not your controlled
substance or DEA number. If you do not remember your license number, your program
coordinator or the Medical Education Office staff can help you. Remember, if you do not
have a license at the time that you are applying, apply as a student.
12. The next page is contact person information. You can click the gray box that states “same
as provider “(which means you) or you can select your program coordinator to receive this
information.
13. On the next page you will be asked to read the information and click a box indicating that
you are responsible for the information. Click “submit” at the bottom of the page.
14. You will be given a tracking number and phone number for follow up.
15. Your NPI number will be sent to the contact person you identified in step 12.
Please Note: If you use personal information to register for your NPI Number, it is important
that you go back and change it to Henry Ford Hospital once you arrive on campus. The NPI site
is available to the public, so using the hospital address protects your privacy.
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