Provider
Class HealthcareProvider

A person or organization which is authorized to perform healthcare-related services.

Attributes
«AD» Address address address

The physical location at which the Healthcare Provider is located or to which mail can be directed.
"The postal address where the practitioner can be found or visited or to which mail can be delivered." - HL7 FHIR, Practitioner.address.

LicensedProvider asLlicensedProvider asLlicensedProvider

Pointer to information about the Provider applicable to their Role of a Licensed Provider.

MedicaidProvider asMedicaidProvider asMedicaidProvider

Pointer to information about the Provider applicable to their Role of a Medicaid Provider.

MedicareProvider asMedicareProvider asMedicareProvider

Pointer to information about the Provider applicable to their Role of a Medicare Provider.

String digitalCertificateDistinguishedName digitalCertificateDistinguishedName

"Distinguished Name field from digital certificate" - ONC S&I Clinical Element Data Dictionary (CEDD), March 2012.

String digitalCertificateId digitalCertificateId

"Serial number from the public digital certificate" - ONC S&I Clinical Element Data Dictionary (CEDD), March 2012.

«II» Id identifier identifier

Uniquely identifies the practitioner. This property should not contain the Tax Id or the National Provider Id, as these types of identifiers are modeled separately.
"An identifier that applies to this person in this role." - HL7 FHIR, Practitioner.identifier.
"The actual identification for the prescriber, pharmacist, et cetera, which is qualified by the Reference Qualifier." - NCPDP Script (Field 1154)
"Defines the Reference number, field 1154. X-12 DE 128. One occurrence is the prescriber number. One occurrence may be used to identify the clinic. One occurrence may be used to identify a supervisor. If the prescriber has an NPI, one occurrence must contain the value HPI (NPI). If the prescriber has a DEA number, one occurrence must contain the value DH (DEA Number). Not every entity allowed to prescribe may have an NPI or DEA. If this is the case, the other identifiers can be used." - NCPDP Script (Field 1153). Possible values include: Certificate to Prescribe (CTP) number (the CTP is an additional number to the state license number that a board of pharmacy assigns to prescribing individuals after completion of specific requirements); DEA number; Dentist License Number; Medicaid Number; Medicare Number; NCPDP Provider ID Number; NPI - National Provider ID; Social Security Number; State License Number; etc.

Boolean isActive isActive

"Whether this practitioner's record is in active use." - HL7 FHIR, Practitioner.active.

«II» Id nationalProviderId nationalProviderId

An identifier that uniquely identifies all persons and organizations who perform medical services within the United States. This identifier is mandated by HIPAA and is maintained by CMS.
"An identifier that applies to this person in this role." - HL7 FHIR, Practitioner.identifier.
"Identifier assigned to the pharmacist by CMS. This number can be used to identify the pharmacist dispensing the medication." - ASAP Standard for PDMP, DSP14: Pharmacist National Provider Identifier (NPI)
"Identifier assigned to the pharmacy by CMS." - ASAP Standard for PDMP, PHA01: National Provider Identifier (NPI)
"Identifier assigned to the prescriber by CMS. " - ASAP Standard for PDMP, PRE01: National Provider Identifier (NPI)

«CS» Code providerCategory providerCategory

Contains a categorization for the practitioner.
Kind of provider. "Defines the usage of this segment. X-12 DE 1221." - NCPDP Script (Field 4705)

ProviderPlanParticipation providerPlanParticipation providerPlanParticipation

Pointer to a participation of a Healthcare Provider (either an Individual or an Organizational Provider) with a Health Plan for the purpose of providing healthcare services to members (i.e., patients) of that plan.

«CS» Code providerRole providerRole

"The list of Roles/Organizations that the Practitioner is associated with." - HL7 FHIR, Practitioner.practitionerRole. Note that FHIR does not identify any values for this concept.

String publicDigitalCertificate publicDigitalCertificate

"A base 64 encoded representation of the public digital certificate" - ONC S&I Clinical Element Data Dictionary (CEDD), March 2012.

Specialty specialty specialty

Pointer to the medical Specialty for which the Healthcare Provider has been certified.
"Specific specialty of the practitioner." - HL7 FHIR, Practitioner.practitionerRole.specialty.

«II» Id taxId taxId

An identifier assigned to the Healthcare Provider by a jurisdictional taxing authority. This id is often used for billing purposes.
"An identifier that applies to this person in this role." - HL7 FHIR, Practitioner.identifier.

«TEL» ContactPoint telecom telecom

Indicates how and at what address that the Healthcare Provider can be reached via electronic communications. The datatype for this property is ContactPoint, which can be used for telephone numbers as well as email, etc. The ContactPoint data type contains a type code to indicate what kind of telecommunications address that is being referenced. Note that this property can contain more than one entry.
"A contact detail for the practitioner, e.g. a telephone number or an email address." - HL7 FHIR, Practitioner.telecom.
"The prescriber's primary phone number" - ASAP Standard for PDMP, PRE08: Phone Number


Properties:

Alias
Classifier Behavior
Is Abstractfalse
Is Activefalse
Is Leaffalse
Keywords
NameHealthcareProvider
Name Expression
NamespaceProvider
Owned Template Signature
OwnerProvider
Owning Template Parameter
PackageProvider
Qualified NameFHIM::Provider::HealthcareProvider
Representation
Stereotype
Template Parameter
VisibilityPublic

Attribute Details

 address
Public «AD» Address address

The physical location at which the Healthcare Provider is located or to which mail can be directed.
"The postal address where the practitioner can be found or visited or to which mail can be delivered." - HL7 FHIR, Practitioner.address.

Constraints:
Properties:

AggregationNone
Alias
Association
Association End
ClassHealthcareProvider
Datatype
Default
Default Value
Is Compositefalse
Is Derivedfalse
Is Derived Unionfalse
Is Leaffalse
Is Orderedfalse
Is Read Onlyfalse
Is Staticfalse
Is Uniquetrue
Keywords
Lower0
Lower Value(0)
Multiplicity*
Nameaddress
Name Expression
NamespaceHealthcareProvider
Opposite
OwnerHealthcareProvider
Owning Association
Owning Template Parameter
Qualified NameFHIM::Provider::HealthcareProvider::address
Stereotype
Template Parameter
Type«AD» Address
Upper*
Upper Value(*)
VisibilityPublic


 asLlicensedProvider
Public LicensedProvider asLlicensedProvider

Pointer to information about the Provider applicable to their Role of a Licensed Provider.

Constraints:
Properties:

AggregationNone
Alias
AssociationhealthcareProvider_licensedProvider
Association End
ClassHealthcareProvider
Datatype
Default
Default Value
Is Compositefalse
Is Derivedfalse
Is Derived Unionfalse
Is Leaffalse
Is Orderedfalse
Is Read Onlyfalse
Is Staticfalse
Is Uniquetrue
Keywords
Lower0
Lower Value(0)
Multiplicity*
NameasLlicensedProvider
Name Expression
NamespaceHealthcareProvider
Opposite
OwnerHealthcareProvider
Owning Association
Owning Template Parameter
Qualified NameFHIM::Provider::HealthcareProvider::asLlicensedProvider
Stereotype
Template Parameter
TypeLicensedProvider
Upper*
Upper Value(*)
VisibilityPublic


 asMedicaidProvider
Public MedicaidProvider asMedicaidProvider

Pointer to information about the Provider applicable to their Role of a Medicaid Provider.

Constraints:
Properties:

AggregationNone
Alias
AssociationhealthcareProvider_asMedicaidProvider
Association End
ClassHealthcareProvider
Datatype
Default
Default Value
Is Compositefalse
Is Derivedfalse
Is Derived Unionfalse
Is Leaffalse
Is Orderedfalse
Is Read Onlyfalse
Is Staticfalse
Is Uniquetrue
Keywords
Lower0
Lower Value(0)
Multiplicity0..1
NameasMedicaidProvider
Name Expression
NamespaceHealthcareProvider
Opposite
OwnerHealthcareProvider
Owning Association
Owning Template Parameter
Qualified NameFHIM::Provider::HealthcareProvider::asMedicaidProvider
Stereotype
Template Parameter
TypeMedicaidProvider
Upper1
Upper Value(1)
VisibilityPublic


 asMedicareProvider
Public MedicareProvider asMedicareProvider

Pointer to information about the Provider applicable to their Role of a Medicare Provider.

Constraints:
Properties:

AggregationNone
Alias
AssociationhealthcareProvider_asMedicareProvider
Association End
ClassHealthcareProvider
Datatype
Default
Default Value
Is Compositefalse
Is Derivedfalse
Is Derived Unionfalse
Is Leaffalse
Is Orderedfalse
Is Read Onlyfalse
Is Staticfalse
Is Uniquetrue
Keywords
Lower0
Lower Value(0)
Multiplicity0..1
NameasMedicareProvider
Name Expression
NamespaceHealthcareProvider
Opposite
OwnerHealthcareProvider
Owning Association
Owning Template Parameter
Qualified NameFHIM::Provider::HealthcareProvider::asMedicareProvider
Stereotype
Template Parameter
TypeMedicareProvider
Upper1
Upper Value(1)
VisibilityPublic


 digitalCertificateDistinguishedName
Public String digitalCertificateDistinguishedName

"Distinguished Name field from digital certificate" - ONC S&I Clinical Element Data Dictionary (CEDD), March 2012.

Constraints:
Properties:

AggregationNone
Alias
Association
Association End
ClassHealthcareProvider
Datatype
Default
Default Value
Is Compositefalse
Is Derivedfalse
Is Derived Unionfalse
Is Leaffalse
Is Orderedfalse
Is Read Onlyfalse
Is Staticfalse
Is Uniquetrue
Keywords
Lower0
Lower Value(0)
Multiplicity0..1
NamedigitalCertificateDistinguishedName
Name Expression
NamespaceHealthcareProvider
Opposite
OwnerHealthcareProvider
Owning Association
Owning Template Parameter
Qualified NameFHIM::Provider::HealthcareProvider::digitalCertificateDistinguishedName
Stereotype
Template Parameter
TypeString
Upper1
Upper Value(1)
VisibilityPublic


 digitalCertificateId
Public String digitalCertificateId

"Serial number from the public digital certificate" - ONC S&I Clinical Element Data Dictionary (CEDD), March 2012.

Constraints:
Properties:

AggregationNone
Alias
Association
Association End
ClassHealthcareProvider
Datatype
Default
Default Value
Is Compositefalse
Is Derivedfalse
Is Derived Unionfalse
Is Leaffalse
Is Orderedfalse
Is Read Onlyfalse
Is Staticfalse
Is Uniquetrue
Keywords
Lower0
Lower Value(0)
Multiplicity0..1
NamedigitalCertificateId
Name Expression
NamespaceHealthcareProvider
Opposite
OwnerHealthcareProvider
Owning Association
Owning Template Parameter
Qualified NameFHIM::Provider::HealthcareProvider::digitalCertificateId
Stereotype
Template Parameter
TypeString
Upper1
Upper Value(1)
VisibilityPublic


 identifier
Public «II» Id identifier

Uniquely identifies the practitioner. This property should not contain the Tax Id or the National Provider Id, as these types of identifiers are modeled separately.
"An identifier that applies to this person in this role." - HL7 FHIR, Practitioner.identifier.
"The actual identification for the prescriber, pharmacist, et cetera, which is qualified by the Reference Qualifier." - NCPDP Script (Field 1154)
"Defines the Reference number, field 1154. X-12 DE 128. One occurrence is the prescriber number. One occurrence may be used to identify the clinic. One occurrence may be used to identify a supervisor. If the prescriber has an NPI, one occurrence must contain the value HPI (NPI). If the prescriber has a DEA number, one occurrence must contain the value DH (DEA Number). Not every entity allowed to prescribe may have an NPI or DEA. If this is the case, the other identifiers can be used." - NCPDP Script (Field 1153). Possible values include: Certificate to Prescribe (CTP) number (the CTP is an additional number to the state license number that a board of pharmacy assigns to prescribing individuals after completion of specific requirements); DEA number; Dentist License Number; Medicaid Number; Medicare Number; NCPDP Provider ID Number; NPI - National Provider ID; Social Security Number; State License Number; etc.

Constraints:
Properties:

AggregationNone
Alias
Association
Association End
ClassHealthcareProvider
Datatype
Default
Default Value
Is Compositefalse
Is Derivedfalse
Is Derived Unionfalse
Is Leaffalse
Is Orderedfalse
Is Read Onlyfalse
Is Staticfalse
Is Uniquetrue
Keywords
Lower1
Lower Value(1)
Multiplicity1..*
Nameidentifier
Name Expression
NamespaceHealthcareProvider
Opposite
OwnerHealthcareProvider
Owning Association
Owning Template Parameter
Qualified NameFHIM::Provider::HealthcareProvider::identifier
Stereotype
Template Parameter
Type«II» Id
Upper*
Upper Value(*)
VisibilityPublic


 isActive
Public Boolean isActive

"Whether this practitioner's record is in active use." - HL7 FHIR, Practitioner.active.

Constraints:
Properties:

AggregationNone
Alias
Association
Association End
ClassHealthcareProvider
Datatype
Default
Default Value
Is Compositefalse
Is Derivedfalse
Is Derived Unionfalse
Is Leaffalse
Is Orderedfalse
Is Read Onlyfalse
Is Staticfalse
Is Uniquetrue
Keywords
Lower0
Lower Value(0)
Multiplicity0..1
NameisActive
Name Expression
NamespaceHealthcareProvider
Opposite
OwnerHealthcareProvider
Owning Association
Owning Template Parameter
Qualified NameFHIM::Provider::HealthcareProvider::isActive
Stereotype
Template Parameter
TypeBoolean
Upper1
Upper Value(1)
VisibilityPublic


 nationalProviderId
Public «II» Id nationalProviderId

An identifier that uniquely identifies all persons and organizations who perform medical services within the United States. This identifier is mandated by HIPAA and is maintained by CMS.
"An identifier that applies to this person in this role." - HL7 FHIR, Practitioner.identifier.
"Identifier assigned to the pharmacist by CMS. This number can be used to identify the pharmacist dispensing the medication." - ASAP Standard for PDMP, DSP14: Pharmacist National Provider Identifier (NPI)
"Identifier assigned to the pharmacy by CMS." - ASAP Standard for PDMP, PHA01: National Provider Identifier (NPI)
"Identifier assigned to the prescriber by CMS. " - ASAP Standard for PDMP, PRE01: National Provider Identifier (NPI)

Constraints:
Properties:

AggregationNone
Alias
Association
Association End
ClassHealthcareProvider
Datatype
Default
Default Value
Is Compositefalse
Is Derivedfalse
Is Derived Unionfalse
Is Leaffalse
Is Orderedfalse
Is Read Onlyfalse
Is Staticfalse
Is Uniquetrue
Keywords
Lower0
Lower Value(0)
Multiplicity*
NamenationalProviderId
Name Expression
NamespaceHealthcareProvider
Opposite
OwnerHealthcareProvider
Owning Association
Owning Template Parameter
Qualified NameFHIM::Provider::HealthcareProvider::nationalProviderId
Stereotype
Template Parameter
Type«II» Id
Upper*
Upper Value(*)
VisibilityPublic


 providerCategory
Public «CS» Code providerCategory

Contains a categorization for the practitioner.
Kind of provider. "Defines the usage of this segment. X-12 DE 1221." - NCPDP Script (Field 4705)

Constraints:
Properties:

AggregationNone
Alias
Association
Association End
ClassHealthcareProvider
Terminologies[
US_Core_R4 US Core Provider Role (NUCC) http://hl7.org/fhir/us/core/ValueSet/us-core-provider-role
]
Datatype
Default
Default Value
Is Compositefalse
Is Derivedfalse
Is Derived Unionfalse
Is Leaffalse
Is Orderedfalse
Is Read Onlyfalse
Is Staticfalse
Is Uniquetrue
Keywords
Lower1
Lower Value(1)
Multiplicity1
NameproviderCategory
Name Expression
NamespaceHealthcareProvider
Opposite
OwnerHealthcareProvider
Owning Association
Owning Template Parameter
Qualified NameFHIM::Provider::HealthcareProvider::providerCategory
StereotypeValueSetConstraints
Template Parameter
Type«CS» Code
Upper1
Upper Value(1)
VisibilityPublic


 providerPlanParticipation
Public ProviderPlanParticipation providerPlanParticipation

Pointer to a participation of a Healthcare Provider (either an Individual or an Organizational Provider) with a Health Plan for the purpose of providing healthcare services to members (i.e., patients) of that plan.

Constraints:
Properties:

AggregationNone
Alias
AssociationhealthcareProvider_providerPlanParticipation
Association End
ClassHealthcareProvider
Datatype
Default
Default Value
Is Compositefalse
Is Derivedfalse
Is Derived Unionfalse
Is Leaffalse
Is Orderedfalse
Is Read Onlyfalse
Is Staticfalse
Is Uniquetrue
Keywords
Lower0
Lower Value(0)
Multiplicity*
NameproviderPlanParticipation
Name Expression
NamespaceHealthcareProvider
OppositehealthcareProvider
OwnerHealthcareProvider
Owning Association
Owning Template Parameter
Qualified NameFHIM::Provider::HealthcareProvider::providerPlanParticipation
Stereotype
Template Parameter
TypeProviderPlanParticipation
Upper*
Upper Value(*)
VisibilityPublic


 providerRole
Public «CS» Code providerRole

"The list of Roles/Organizations that the Practitioner is associated with." - HL7 FHIR, Practitioner.practitionerRole. Note that FHIR does not identify any values for this concept.

Constraints:
Properties:

AggregationNone
Alias
Association
Association End
ClassHealthcareProvider
Terminologies[
C-CDA_2.1 Healthcare Provider Taxonomy 2.16.840.1.114222.4.11.1066
,
HL7_FHIR_R4 Practitioner role http://hl7.org/fhir/ValueSet/practitioner-role
,
US_Core_R4 US Core Provider Specialty (NUCC) http://hl7.org/fhir/us/core/ValueSet/us-core-provider-specialty
]
Datatype
Default
Default Value
Is Compositefalse
Is Derivedfalse
Is Derived Unionfalse
Is Leaffalse
Is Orderedfalse
Is Read Onlyfalse
Is Staticfalse
Is Uniquetrue
Keywords
Lower1
Lower Value(1)
Multiplicity1
NameproviderRole
Name Expression
NamespaceHealthcareProvider
Opposite
OwnerHealthcareProvider
Owning Association
Owning Template Parameter
Qualified NameFHIM::Provider::HealthcareProvider::providerRole
StereotypeValueSetConstraints
Template Parameter
Type«CS» Code
Upper1
Upper Value(1)
VisibilityPublic


 publicDigitalCertificate
Public String publicDigitalCertificate

"A base 64 encoded representation of the public digital certificate" - ONC S&I Clinical Element Data Dictionary (CEDD), March 2012.

Constraints:
Properties:

AggregationNone
Alias
Association
Association End
ClassHealthcareProvider
Datatype
Default
Default Value
Is Compositefalse
Is Derivedfalse
Is Derived Unionfalse
Is Leaffalse
Is Orderedfalse
Is Read Onlyfalse
Is Staticfalse
Is Uniquetrue
Keywords
Lower0
Lower Value(0)
Multiplicity0..1
NamepublicDigitalCertificate
Name Expression
NamespaceHealthcareProvider
Opposite
OwnerHealthcareProvider
Owning Association
Owning Template Parameter
Qualified NameFHIM::Provider::HealthcareProvider::publicDigitalCertificate
Stereotype
Template Parameter
TypeString
Upper1
Upper Value(1)
VisibilityPublic


 specialty
Public Specialty specialty

Pointer to the medical Specialty for which the Healthcare Provider has been certified.
"Specific specialty of the practitioner." - HL7 FHIR, Practitioner.practitionerRole.specialty.

Constraints:
Properties:

AggregationNone
Alias
AssociationhealthcareProvider_specialty
Association End
ClassHealthcareProvider
Datatype
Default
Default Value
Is Compositefalse
Is Derivedfalse
Is Derived Unionfalse
Is Leaffalse
Is Orderedfalse
Is Read Onlyfalse
Is Staticfalse
Is Uniquefalse
Keywords
Lower0
Lower Value(0)
Multiplicity*
Namespecialty
Name Expression
NamespaceHealthcareProvider
Opposite
OwnerHealthcareProvider
Owning Association
Owning Template Parameter
Qualified NameFHIM::Provider::HealthcareProvider::specialty
Stereotype
Template Parameter
TypeSpecialty
Upper*
Upper Value(*)
VisibilityPublic


 taxId
Public «II» Id taxId

An identifier assigned to the Healthcare Provider by a jurisdictional taxing authority. This id is often used for billing purposes.
"An identifier that applies to this person in this role." - HL7 FHIR, Practitioner.identifier.

Constraints:
Properties:

AggregationNone
Alias
Association
Association End
ClassHealthcareProvider
Datatype
Default
Default Value
Is Compositefalse
Is Derivedfalse
Is Derived Unionfalse
Is Leaffalse
Is Orderedfalse
Is Read Onlyfalse
Is Staticfalse
Is Uniquetrue
Keywords
Lower0
Lower Value(0)
Multiplicity0..1
NametaxId
Name Expression
NamespaceHealthcareProvider
Opposite
OwnerHealthcareProvider
Owning Association
Owning Template Parameter
Qualified NameFHIM::Provider::HealthcareProvider::taxId
Stereotype
Template Parameter
Type«II» Id
Upper1
Upper Value(1)
VisibilityPublic


 telecom
Public «TEL» ContactPoint telecom

Indicates how and at what address that the Healthcare Provider can be reached via electronic communications. The datatype for this property is ContactPoint, which can be used for telephone numbers as well as email, etc. The ContactPoint data type contains a type code to indicate what kind of telecommunications address that is being referenced. Note that this property can contain more than one entry.
"A contact detail for the practitioner, e.g. a telephone number or an email address." - HL7 FHIR, Practitioner.telecom.
"The prescriber's primary phone number" - ASAP Standard for PDMP, PRE08: Phone Number

Constraints:
Properties:

AggregationNone
Alias
Association
Association End
ClassHealthcareProvider
Datatype
Default
Default Value
Is Compositefalse
Is Derivedfalse
Is Derived Unionfalse
Is Leaffalse
Is Orderedfalse
Is Read Onlyfalse
Is Staticfalse
Is Uniquetrue
Keywords
Lower0
Lower Value(0)
Multiplicity*
Nametelecom
Name Expression
NamespaceHealthcareProvider
Opposite
OwnerHealthcareProvider
Owning Association
Owning Template Parameter
Qualified NameFHIM::Provider::HealthcareProvider::telecom
Stereotype
Template Parameter
Type«TEL» ContactPoint
Upper*
Upper Value(*)
VisibilityPublic