Join our Provider Network

Thank you for your interest in becoming a participating provider with Independent Health. Please complete the following steps to begin the process for Independent Health to consider your participation in our networks.


Step 1

Download and complete the Provider Application Request Form. E-mail the completed form to

Please note: the Provider Application Request Form is not the application for participation. Independent Health will evaluate your request for a Provider Application based on our network needs.

If Independent Health accepts your request for an application, please follow Step 2.


Step 2

Register/Update with The Council for Affordable Quality Healthcare (CAQH). You will have to list Independent Health as an authorized viewer online with CAQH.

If you do not have your CAQH ID, call CAQH at 1-888-599-1771.

Once you have completed your registration and have listed Independent Health as an authorized viewer, Independent Health will begin the credentialing process.

Independent Health credentials these Health Care Professionals: Physicians (MD,DO), Nurse Practitioners (NP), Physician Assistants (PA), Licensed Nurse Midwives (LNM), Certified Registered Nurse Anesthetists (CRNA), Independent Nurse Practitioners (INP), Licensed Certified Social Workers (LCSW-R), Physical Therapists (PT), Occupational Therapists (OT), Speech Language Pathologists (SLP), Registered Dietitians (RD), Optometrists (OD), Psychologists (PhD), Audiologists (AUD), Licensed Dentists (DDS), Chiropractors (DC), Podiatrists (DPM), Licensed Behavior Analyst (LBA), and Certified Behavior Analyst Assistants (CBAA).


  • Incomplete applications will delay the processing time.
  • You may not provide services to Independent Health members until you are credentialed and all appropriate contracts are fully executed.