Mount Carmel Health System

Because of You

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Initial Appointment

In order to become a member of our medical staff, you must submit a completed application. The documents listed below are considered, in their entirety, your application. Please note that your application will not be considered or processed until all of these documents are completed and received:

We utilize the Council for Affordable Quality Healthcare (CAQH) application as part of the credentialing process, which, according to H.B. 125, The Healthcare Simplification Act, is the only acceptable application for physician credentialing and reappointment in Ohio. You can find information on the CAQH application process at: www.caqh.org. If you have not completed a CAQH application online and need to be assigned a CAQH ID number, contact the Credentialing Verification Office at 614-546-3540.

You must print, sign and include the following forms with your application:

Please submit your completed application and documentation to:

Mount Carmel Health System
Credentialing Verification Office (CVO) – 3rd Floor
6150 E. Broad Street, Columbus, OH 43213
Phone: 614-546-3540
Fax: 614-546-3542

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Mount Carmel Health System  |  Columbus, Ohio

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