Become a Credentialed Provider
Provider Credentialing Application Forum Dates
The Provider Credentialing Forums are held quarterly, two (2) times within the same month, Central Standard Time (CST). The Forums are virtual, on the day and time of the meeting, click the meeting date and follow the detail to join.
Date: July 23, 2026
Time : 9:00 AM- 12: 00 PM Central Standard Time
Platform: Webex
To join: Click the Join Link or Join by Phone
Join link:
https://tn.webex.com/tn/j.php?MTID=mb4d03b31394ba4288abefcfd8ceb4309
Webinar number:
2300 025 2947
Webinar password:
DKm3qkK3cK6 (35637553 when dialing from a phone or video system)
Join by phone
+1 615-747-4911 Webex Call-In
+1-415-655-0001 US Toll
Access code: 2300 025 2947
July 30, 2026
Time : 9:00 AM- 12: 00 PM Central Standard Time
Platform: Webex
To join: Click the Join Link or Join by Phone
Join link:
https://tn.webex.com/tn/j.php?MTID=m8ff697a6453f5a0fdc1a0aea9231f614
Webinar number:
2301 254 4902
Webinar password:
pmWfjZBq786 (76935927 when dialing from a phone or video system)
Join by phone
+1 615-747-4911 Webex Call-In
+1-415-655-0001 US Toll
Access code: 2301 254 4902
1. Submit the application to DDA.Provider.Application@tn.gov
2. Type in the Subject section your organization’s name and the region (West, or Middle, or East, or Statewide*) you are requesting the service
* Statewide applies If you are applying for more than one region
3. For each uploaded document label the document’s name. See Attachment 1 for the list of appropriate documents to upload according to your selected service(s).
For Example:
- Credentialing Application
- TN Business State License and/or County of TN Business License, as applicable
- Disclosure Form
- Tax Forms (W-9, IRS 147c and Substitute W-9)
If each uploaded document is not named this may delay the downloading process and impact credentialing of your application. Graphic files such as: JPEG (photo) or TIFF, will not be accepted.
Note: Due to documentation uploading capacity limitation, you may need to continue uploads onto more than one submission. Remember for each submission, type in the Subject line type your organization’s name and the region (West, Middle, or East, or Statewide*) you are requesting the service. Also label the name of each uploaded document.
* Statewide applies If you are applying for more than one region
Note: If you decide to upload a ZIP FILE. Please ensure the uploaded file states the name of your organization and the region. Also label the name of each document within the ZIP FILE.
4. DDA will email confirmation of your application within two (2) business days. It is very important you contact DDA if you do not receive this email.
5. Please allow 30 calendar days before requesting the status of your application.
6. For questions, contact the DDA Provider Enrollment Coordinator by email at DDA.Provider.Application@tn.gov or phone (615) 532-6530
Very Important: The Prerequisites must be completed prior to submission of your Credentialing application. Please see the Prerequisites section of the application.
- Attachment 1: Credentialing Standards
- Attachment 2: Licensing Requirements
- Attachment 3: Provider Credentialing Policy Req
- Minimum Required Policies and Review Guidelines
- Attachment 4: Service Definitions (see specific program definitions below)