Membership Request Information

We appreciate your interest in joining Baptist Physician Partners. Please complete this form to submit a membership application request and a member of our team will contact you.

Applicants are reviewed and considered for membership in Baptist Physician Partners on an individual basis. The criteria includes, but is not limited to, the provider’s commitment to improve the health of patients served by the Network, provider’s qualifications, provider’s practice history in the community, and the Network geographic and specialty needs at the time of enrollment. Your inclusion in BPP will become effective only after approval by the BPP Board of Managers.



Member Request/Information

Are you a new applicant to BPP, or existing group adding new Provider(s)?

Are you a solo provider?

Please complete the fields for your practice at the Tax ID level and each of your providers to be considered for BPP membership.

Add Another Location

Provider 1

Board Certified/Eligible?

Maintain Privileges at a Baptist Health Facility?

Add Another Provider