NM1

Rendering Provider Name

Pos: 250	Max: 1
Detail - Optional
Loop: 2310B	Elements: 8

Ref

Id

Element Name

Req

Type

Min/Max

Usage

NM101

98

Entity Identifier Code
Description: Code identifying an organizational entity, a physical location, property or an individual
The entity identifier in NM101 applies to all segments in this Loop ID-2310.

M

ID

2/3

Required

Code

Name

82

Rendering Provider

NM102

1065

Entity Type Qualifier
Description: Code qualifying the type of entity

M

ID

1/1

Required

Code

Name

1

Person

2

Non-Person Entity

NM103

1035

Name Last or Organization Name
Description: Individual last name or organizational name
Industry: Rendering Provider Last or Organization Name
Alias: Rendering Provider Last Name
NSF Reference: FB1-14.0

O

AN

1/35

Required

NM104

1036

Name First
Description: Individual first name
Industry: Rendering Provider First Name
NSF Reference: FB1-15.0
Required if NM102=1 (person).

O

AN

1/25

Situational

NM105

1037

Name Middle
Description: Individual middle name or initial
Industry: Rendering Provider Middle Name
NSF Reference: FB1-16.0
Required if NM102=1 and the middle name/initial of the person is known.

O

AN

1/25

Situational

NM107

1039

Name Suffix
Description: Suffix to individual name
Industry: Rendering Provider Name Suffix
Alias: Rendering Provider Generation
Required if known.

O

AN

1/10

Situational

NM108

66

Identification Code Qualifier
Description: Code designating the system/method of code structure used for Identification Code (67)
NSF Reference: FA0-57.0
FA0-57.0 crosswalk is only used in Medicare COB payer-to-payer claims.

C

ID

1/2

Required

Code

Name

24

Employer's Identification Number

34

Social Security Number

XX

Health Care Financing Administration National Provider Identifier

NM109

67

Identification Code
Description: Code identifying a party or other code
Industry: Rendering Provider Identifier
Alias: Rendering Provider Primary Identifier
NSF Reference: FA0-23.0, FA0-58.0
FA0-58.0 crosswalk is only used in Medicare COB payer-to-payer claims.

C

AN

2/80

Required

ExternalCodeList

Name: 537

Description: Health Care Financing Administration National Provider Identifier

1.

P0809 - If either NM108,NM109 is present, then all are required

2.

C1110 - If NM111 is present, then all of NM110 are required

1.

NM102 qualifies NM103.

1.

NM110 and NM111 further define the type of entity in NM101.

Notes:

1. Information in Loop ID-2310 applies to the entire claim unless overridden on a service line by the presence of Loop ID-2420 with the same value in NM101.
2. Because the usage of this segment is “Situational” this is not a syntactically required loop. If this loop is used, then this segment is a “Required” segment. See Appendix A for further details on ASC X12 syntax rules.
3. Required when the Rendering Provider NM1 information is different than that carried in either the Billing Provider NM1 or the Pay-to Provider NM1 in the 2010AA/AB loops respectively.
4. Used for all types of rendering providers including laboratories. The Rendering Provider is the person or company (laboratory or other facility) who rendered the care. In the case where a subsitute provider (locum tenans) was used, that person should be entered here.

Example:

NM1*82*1*BEATTY*GARY*C**SR*XX*12345678~