Network intake

Join OpenRx network

Apply as a provider or caregiver through one structured intake. OpenRx routes the application to admin review with signed email actions instead of a spreadsheet-driven backlog.

provider review0/16 required checks complete

Role

Provider

The application language and verification expectations shift with the selected role.

Verification

NPI + state license

Providers need an individual NPI, license number, license state, and ordering-scope attestation before review.

Coverage area

ZIP pending

Add a city, state, and ZIP so OpenRx can place the application correctly.

Regulatory posture

Human review required

OpenRx must verify patient-state licensure and ordering authority before matching patients to a script/order workflow.

Application

Tell OpenRx who you are, where you practice, and what care you provide.

This is a credentialing-style intake, not a marketing form. The goal is enough structured detail for the admin team to verify identity, geography, and service fit in one pass.

Admin review uses

Identity verification through NPI or license data when applicable.
Service fit review for the patient populations and care tasks you described.
Geographic review so the profile lands in the right matching area.

Role selection

Pick the intake path that matches your work so the verification expectations stay explicit.

Full name

Phone

Specialty

Examples: family medicine, oncology, neurology.

NPI

Use an individual NPI for ordering/referring review. Organizational NPIs do not establish individual authority.

License number

Required for state-board verification before any patient matching.

Primary license state

2-letter state where this license is active.

Other licensed statesOptional

Comma-separated state abbreviations. Example: OR, WA, CA.

Ordering / certifying status

Needed before routing patients for labs, imaging, home health, or other ordered services.

Professional liability coverage

Carrier or coverage note. Admin still verifies before approval.

Provider regulatory attestations

OpenRx does not auto-approve clinicians or bypass patient-state licensure, payer, ordering, or prescription requirements. These attestations route the application to human review.

I hold an active, unrestricted license in every state where I will treat or order for OpenRx patients, and I understand patient location must be verified before telehealth care.I will only order labs, imaging, referrals, prescriptions, or certifications that are within my license, specialty, payer enrollment, and state scope.I understand OpenRx agents may prepare work, but no prescription, diagnostic order, referral, claim, or prior authorization is submitted under my name without my explicit review and approval.I maintain professional liability coverage appropriate for the services and states listed in this application.

Services summary

Describe who you serve, the services you offer, and any availability details that matter for matching.

City

State

Use the 2-letter abbreviation.

ZIP

5 digits.

OpenRx sends the intake into signed admin review. Nothing goes live automatically.