The Right Information, All The Time

Great Lakes Health Connect values your partnership in building care connected communities. Together we strive to improve health outcomes and healthcare value for patients, providers, and payers across Michigan and beyond. In achieving this goal, protecting patient health information must be a top priority. Therefore, keeping us well-informed of provider changes in your organization is crucial to ensuring that the right information gets to the right place at the right time.

The Provider Update Request process has been enhanced to meet the needs of our growing community. The Provider Update Request User Guide provides instructions on how to access and complete the form.


  1. How many Providers need to be updated?
  2. Find relevant provider codes

Forms that are missing required information will be returned to the requester.

Immediate change requests will be processed within 3 business days. GLHC will inform all applicable hospitals of your provider changes.

If you have any questions, please contact your local Implementation Consultant or GLHC Support at or at 844-454-2443, option 2.

  • Example: Practice Manager, Office Manager, Administrator
  • No abbreviations
  • Last Name*First Name*Middle Initial*Credentials*National Provider Identifier (NPI) (*ADT Notifications)State License NumberEMR Provider Code (*Results delivery into your EMR)Start DateEnd Date 
    Note: Fields will expand as text is entered. To add another line click the plus sign on the right. Only one date field is required, estimate if needed.
  • This field is for validation purposes and should be left unchanged.