SAMPLE for the demonstration: a fictional certificate, not a real document. In real use this is the scan or PDF the coordinator attaches.

Payer enrollment

Ridgeline Health Partners credential file

Issued toCaleb Foster, PA-C
CredentialPayer enrollment (HARB)
NumberHARB-ENR-DEMO-4100
Issued byHarborline Health
Valid fromApr 8, 2024
Valid throughApr 8, 2027

Fictional provider and number. Close this tab to return to the Credential Tracker.