1915(i) Provider Enrollment

Prior to beginning the 1915(i) Provider Enrollment process, please reach out to nd1915i@nd.gov. There are many training and policy requirements involved with providing 1915(i) services, and the 1915(i) Administration Team strives to ensure providers are well informed, have a positive enrollment experience, and have the information and support they need to enjoy ongoing success. 

In order to provide 1915(i) services, an agency must first complete the group enrollment process for 1915(i), then also enroll individual providers to affiliate with their group. 

Group enrollment requires completion of steps 1-4 below. Upon receiving notification of an approved group enrollment, an agency must ensure their individual providers enroll.

Individual enrollment requires the completion of steps 1-3 below. 

Group providers may also affiliate individuals currently enrolled under a different group by submitting the SFN 1330 Request to Add an Affiliation Form linked below under the "Enrollment Resources" tab. Individuals may be affiliated with multiple group providers. If an individual leaves employment with an agency, the agency should complete the SFN 1331 Termination Form linked below under the "Enrollment Resources" tab.

Individual provider enrollment will not be approved without an affiliation to a group.