Provider Name,Credential Type,License/ID Number,State,Issue Date,Expiration Date,Notes
Dr. Sarah Chen,Medical License,A123456,CA,2023-01-15,2026-01-15,Renewal notice goes to practice address
Dr. Michael Rodriguez,DEA Registration,MR9876543,TX,2024-03-01,2027-03-01,Requires CME verification for renewal
Dr. Emily Thompson,CAQH ProView,1234567890,NY,2025-06-01,2026-06-15,Verify NPI match before submission
Dr. James Wilson,Malpractice Insurance,POL-2024-78901,FL,2023-11-01,2026-11-01,Requires updated claims history report
Dr. Priya Patel,Board Certification,CERT-2024-45678,IL,2024-05-01,2027-05-01,CME credits must be uploaded 60 days prior
Dr. Robert Kim,NPI Revalidation,1234567890,PA,2025-09-01,2026-07-01,Revalidation window opens 120 days before expiration
Dr. Lisa Martinez,Medical License,MD-2024-3321,OH,2024-06-01,2026-05-01,Reciprocal license pending in Michigan
Dr. Angela Brooks,Other (Hospital Privileges),PRIV-8876,GA,2024-05-01,2025-05-01,Requires updated immunization records