← Readiness queue
PRV-4006
ReadySynthetic provider file · no real PII / no PHICertified nurse midwife · OB/GYN · TRH Main — Women's
Weighted readiness
100
6/6 checks verified
Deadline
155d
Recredential due 2026-12-14
Flags
exclusion clear
Primary-source verification checklist
| Dimension | Status | Detail | Primary source | Weight |
|---|---|---|---|---|
| State license (APRN) | Verified | Active | BON primary source (batch PSV) | 25% |
| DEA registration | Verified | Active | DEA CSA registry (batch) | 15% |
| Certification (AMCB) | Verified | Current | AMCB (batch) | 15% |
| Payer enrollment (Aetna) | Verified | Active, PAR | Aetna enrollment export | 20% |
| OIG-LEIE / SAM exclusion | Verified | No match on last batch screen | OIG-LEIE + SAM.gov (batch) | 15% |
| Malpractice coverage | Verified | Current | COI on file | 10% |
Evidence provenance
- Owner
- R. Okafor
- Evidence
- Credentialing packet PRV-4006 · PSV batch 06-30
- Linked agreement
- Commercial Payer Participation Agreement
Readiness workflow
Demo action — resets on reload · not persistedChronology & session activity
- seed2026-06-30 — PRV-4006 surfaced by VERIFY readiness rule from the Credentialing + PSV batch extract · FY2026 Q3.
- seed2026-06-30 — Primary-source verification results reconciled against agreement scope and payer enrollment.