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Update Your Information

When to Notify Us

Update Wellmark with:

• Changes in taxpayer identification numbers
• Changes in demographic information (addresses, suite numbers, phone numbers, name changes, specialty changes, etc.)
• Changes in practice status (closing, relocation, change of ownership, etc.)
• Adding a location
• Change in National Provider Identifier (NPI)

Wellmark will review your request and let you know within 30 days if further actions are necessary (such as a change in your provider number or contract, or a site visit).

How to Notify Us

• To report changes in your address, name, specialty, or Taxpayer ID, complete the Provider Change Form. A completed W-9 Form  (250KB) must accompany any Taxpayer ID change.
• To add a location, or to change both your Taxpayer ID and your address, complete the Iowa Statewide Universal Facility Application  (775KB).
• To report a change in your NPI, use the NPI Notification Form and select the "Change Existing Notification" option.
• To check on the status of a request previously sent, call us at 1-800-708-1342 or 515-245-5100, or e-mail us at providercredentialing@wellmark.com . We will respond to your inquiry within 24 hours of receipt.