US Core Implementation Guide
7.0.0 - CI Build United States of America flag

US Core Implementation Guide, published by HL7 International / Cross-Group Projects. This guide is not an authorized publication; it is the continuous build for version 7.0.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/US-Core/ and changes regularly. See the Directory of published versions

Resource Profile: USCorePractitionerProfile - Detailed Descriptions

Page standards status: Trial-use Maturity Level: 3

Definitions for the us-core-practitioner resource profile.

Guidance on how to interpret the contents of this table can be found here

0. Practitioner
Must Supportfalse
Alternate NamesProvider
2. Practitioner.identifier
Comments

NPI must be supported as the identifier system in the US, Tax id is allowed, Local id is allowed in addition to another identifier supplied by a jurisdictional authority such as a practitioner's Drug Enforcement Administration (DEA) number.

NoteThis is a business identifier, not a resource identifier (see discussion)
Control1..?
Must Supporttrue
SlicingThis element introduces a set of slices on Practitioner.identifier. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • pattern @ $this
  • 4. Practitioner.identifier.system
    Control1..1
    Typeuri
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Must Supporttrue
    6. Practitioner.identifier.value
    Control1..1
    Typestring
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Must Supporttrue
    8. Practitioner.identifier:NPI
    Slice NameNPI
    NoteThis is a business identifier, not a resource identifier (see discussion)
    Must Supporttrue
    Pattern Value{
      "system" : "http://hl7.org/fhir/sid/us-npi"
    }
    Invariantsus-core-16: NPI must be 10 digits (value.matches('^[0-9]{10}$'))
    us-core-17: NPI check digit must be valid (Luhn algorithm check) ((((select(value.substring(0,1).toInteger()).select(iif($this<5, $this*2, (($this*2)-9))))+(value.substring(1,1).toInteger())+(select(value.substring(2,1).toInteger()).select(iif($this<5, $this*2, (($this*2)-9))))+(value.substring(3,1).toInteger())+(select(value.substring(4,1).toInteger()).select(iif($this<5, $this*2, (($this*2)-9))))+(value.substring(5,1).toInteger())+(select(value.substring(6,1).toInteger()).select(iif($this<5, $this*2, (($this*2)-9))))+(value.substring(7,1).toInteger())+(select(value.substring(8,1).toInteger()).select(iif($this<5, $this*2, (($this*2)-9))))+(value.substring(9,1).toInteger()) + 24)mod 10=0))
    10. Practitioner.name
    Control1..?
    Must Supporttrue
    12. Practitioner.name.family
    Control1..1
    Typestring
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Must Supporttrue
    14. Practitioner.telecom
    Must Supporttrue
    16. Practitioner.telecom.system
    Must Supporttrue
    18. Practitioner.telecom.value
    Must Supporttrue
    20. Practitioner.address
    Definition

    Address(es) of the practitioner

    ShortAddress(es) of the practitioner
    Must Supporttrue
    Requirements

    -

    22. Practitioner.address.line
    Control0..4
    Typestring
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Must Supporttrue
    Example<br/><b>General</b>:49 MEADOW ST
    24. Practitioner.address.city
    Control0..1
    Typestring
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Must Supporttrue
    Example<br/><b>General</b>:EVERYTOWN
    26. Practitioner.address.state
    Control0..1
    BindingUnless not suitable, these codes SHALL be taken from USPS Two Letter Alphabetic Codes
    (extensible to http://hl7.org/fhir/us/core/ValueSet/us-core-usps-state)

    Two letter USPS alphabetic codes.

    Typestring
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Must Supporttrue
    Example<br/><b>General</b>:OK
    28. Practitioner.address.postalCode
    ShortUS Zip Codes
    Control0..1
    Typestring
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Must Supporttrue
    Example<br/><b>General</b>:74047
    30. Practitioner.address.country
    Control0..1
    Typestring
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Must Supporttrue

    Guidance on how to interpret the contents of this table can be found here

    0. Practitioner
    Definition

    A person who is directly or indirectly involved in the provisioning of healthcare.

    ShortA person with a formal responsibility in the provisioning of healthcare or related services
    Control0..*
    Is Modifierfalse
    Must Supportfalse
    Summaryfalse
    Alternate NamesProvider
    Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
    dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty())
    dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
    dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
    dom-6: A resource should have narrative for robust management (text.`div`.exists())
    2. Practitioner.implicitRules
    Definition

    A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

    ShortA set of rules under which this content was created
    Comments

    Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

    Control0..1
    Typeuri
    Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    4. Practitioner.modifierExtension
    Definition

    May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

    Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

    ShortExtensions that cannot be ignored
    Comments

    There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

    Control0..*
    TypeExtension
    Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
    Summaryfalse
    Requirements

    Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

    Alternate Namesextensions, user content
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    6. Practitioner.identifier
    Definition

    An identifier that applies to this person in this role.

    ShortAn identifier for the person as this agent
    Comments

    NPI must be supported as the identifier system in the US, Tax id is allowed, Local id is allowed in addition to another identifier supplied by a jurisdictional authority such as a practitioner's Drug Enforcement Administration (DEA) number.

    NoteThis is a business identifier, not a resource identifier (see discussion)
    Control10..*
    TypeIdentifier
    Is Modifierfalse
    Must Supporttrue
    Summarytrue
    Requirements

    Often, specific identities are assigned for the agent.

    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    SlicingThis element introduces a set of slices on Practitioner.identifier. The slices are unordered and Open, and can be differentiated using the following discriminators:
    • pattern @ $this
    • 8. Practitioner.identifier.use
      Definition

      The purpose of this identifier.

      Shortusual | official | temp | secondary | old (If known)
      Comments

      Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

      Control0..1
      BindingThe codes SHALL be taken from IdentifierUsehttp://hl7.org/fhir/ValueSet/identifier-use|4.0.1
      (required to http://hl7.org/fhir/ValueSet/identifier-use|4.0.1)

      Identifies the purpose for this identifier, if known .

      Typecode
      Is Modifiertrue because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summarytrue
      Requirements

      Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      10. Practitioner.identifier.system
      Definition

      Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

      ShortThe namespace for the identifier value
      Comments

      Identifier.system is always case sensitive.

      Control10..1
      Typeuri
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Must Supporttrue
      Summarytrue
      Requirements

      There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

      Example<br/><b>General</b>:http://www.acme.com/identifiers/patient
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      12. Practitioner.identifier.value
      Definition

      The portion of the identifier typically relevant to the user and which is unique within the context of the system.

      ShortThe value that is unique
      Comments

      If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.

      Control10..1
      Typestring
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Must Supporttrue
      Summarytrue
      Example<br/><b>General</b>:123456
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      14. Practitioner.identifier:NPI
      Slice NameNPI
      Definition

      An identifier that applies to this person in this role.

      ShortAn identifier for the person as this agent
      NoteThis is a business identifier, not a resource identifier (see discussion)
      Control0..*
      This element is affected by the following invariants: us-core-16, us-core-17
      TypeIdentifier
      Is Modifierfalse
      Must Supporttrue
      Summarytrue
      Requirements

      Often, specific identities are assigned for the agent.

      Pattern Value{
        "system" : "http://hl7.org/fhir/sid/us-npi"
      }
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      us-core-16: NPI must be 10 digits (value.matches('^[0-9]{10}$'))
      us-core-17: NPI check digit must be valid (Luhn algorithm check) ((((select(value.substring(0,1).toInteger()).select(iif($this<5, $this*2, (($this*2)-9))))+(value.substring(1,1).toInteger())+(select(value.substring(2,1).toInteger()).select(iif($this<5, $this*2, (($this*2)-9))))+(value.substring(3,1).toInteger())+(select(value.substring(4,1).toInteger()).select(iif($this<5, $this*2, (($this*2)-9))))+(value.substring(5,1).toInteger())+(select(value.substring(6,1).toInteger()).select(iif($this<5, $this*2, (($this*2)-9))))+(value.substring(7,1).toInteger())+(select(value.substring(8,1).toInteger()).select(iif($this<5, $this*2, (($this*2)-9))))+(value.substring(9,1).toInteger()) + 24)mod 10=0))
      16. Practitioner.name
      Definition

      The name(s) associated with the practitioner.

      ShortThe name(s) associated with the practitioner
      Comments

      The selection of the use property should ensure that there is a single usual name specified, and others use the nickname (alias), old, or other values as appropriate.

      In general, select the value to be used in the ResourceReference.display based on this:

      1. There is more than 1 name
      2. Use = usual
      3. Period is current to the date of the usage
      4. Use = official
      5. Other order as decided by internal business rules.
      Control10..*
      TypeHumanName
      Is Modifierfalse
      Must Supporttrue
      Summarytrue
      Requirements

      The name(s) that a Practitioner is known by. Where there are multiple, the name that the practitioner is usually known as should be used in the display.

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      18. Practitioner.name.use
      Definition

      Identifies the purpose for this name.

      Shortusual | official | temp | nickname | anonymous | old | maiden
      Comments

      Applications can assume that a name is current unless it explicitly says that it is temporary or old.

      Control0..1
      BindingThe codes SHALL be taken from NameUsehttp://hl7.org/fhir/ValueSet/name-use|4.0.1
      (required to http://hl7.org/fhir/ValueSet/name-use|4.0.1)

      The use of a human name.

      Typecode
      Is Modifiertrue because This is labeled as "Is Modifier" because applications should not mistake a temporary or old name etc.for a current/permanent one
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summarytrue
      Requirements

      Allows the appropriate name for a particular context of use to be selected from among a set of names.

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      20. Practitioner.name.family
      Definition

      The part of a name that links to the genealogy. In some cultures (e.g. Eritrea) the family name of a son is the first name of his father.

      ShortFamily name (often called 'Surname')
      Comments

      Family Name may be decomposed into specific parts using extensions (de, nl, es related cultures).

      Control10..1
      Typestring
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Must Supporttrue
      Summarytrue
      Alternate Namessurname
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      22. Practitioner.telecom
      Definition

      A contact detail for the practitioner, e.g. a telephone number or an email address.

      ShortA contact detail for the practitioner (that apply to all roles)
      Comments

      Person may have multiple ways to be contacted with different uses or applicable periods. May need to have options for contacting the person urgently and to help with identification. These typically will have home numbers, or mobile numbers that are not role specific.

      Control0..*
      TypeContactPoint
      Is Modifierfalse
      Must Supporttrue
      Summarytrue
      Requirements

      Need to know how to reach a practitioner independent to any roles the practitioner may have.

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      24. Practitioner.telecom.system
      Definition

      Telecommunications form for contact point - what communications system is required to make use of the contact.

      Shortphone | fax | email | pager | url | sms | other
      Control0..1
      This element is affected by the following invariants: cpt-2
      BindingThe codes SHALL be taken from ContactPointSystemhttp://hl7.org/fhir/ValueSet/contact-point-system|4.0.1
      (required to http://hl7.org/fhir/ValueSet/contact-point-system|4.0.1)

      Telecommunications form for contact point.

      Typecode
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Must Supporttrue
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      26. Practitioner.telecom.value
      Definition

      The actual contact point details, in a form that is meaningful to the designated communication system (i.e. phone number or email address).

      ShortThe actual contact point details
      Comments

      Additional text data such as phone extension numbers, or notes about use of the contact are sometimes included in the value.

      Control0..1
      Typestring
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Must Supporttrue
      Summarytrue
      Requirements

      Need to support legacy numbers that are not in a tightly controlled format.

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      28. Practitioner.telecom.use
      Definition

      Identifies the purpose for the contact point.

      Shorthome | work | temp | old | mobile - purpose of this contact point
      Comments

      Applications can assume that a contact is current unless it explicitly says that it is temporary or old.

      Control0..1
      BindingThe codes SHALL be taken from ContactPointUsehttp://hl7.org/fhir/ValueSet/contact-point-use|4.0.1
      (required to http://hl7.org/fhir/ValueSet/contact-point-use|4.0.1)

      Use of contact point.

      Typecode
      Is Modifiertrue because This is labeled as "Is Modifier" because applications should not mistake a temporary or old contact etc.for a current/permanent one
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summarytrue
      Requirements

      Need to track the way a person uses this contact, so a user can choose which is appropriate for their purpose.

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      30. Practitioner.address
      Definition

      Address(es) of the practitioner


      Address(es) of the practitioner that are not role specific (typically home address). Work addresses are not typically entered in this property as they are usually role dependent.

      ShortAddress(es) of the practitionerAddress(es) of the practitioner that are not role specific (typically home address)
      Comments

      The PractitionerRole does not have an address value on it, as it is expected that the location property be used for this purpose (which has an address).

      Control0..*
      TypeAddress
      Is Modifierfalse
      Must Supporttrue
      Summarytrue
      Requirements

      -


      The home/mailing address of the practitioner is often required for employee administration purposes, and also for some rostering services where the start point (practitioners home) can be used in calculations.

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      32. Practitioner.address.use
      Definition

      The purpose of this address.

      Shorthome | work | temp | old | billing - purpose of this address
      Comments

      Applications can assume that an address is current unless it explicitly says that it is temporary or old.

      Control0..1
      BindingThe codes SHALL be taken from AddressUsehttp://hl7.org/fhir/ValueSet/address-use|4.0.1
      (required to http://hl7.org/fhir/ValueSet/address-use|4.0.1)

      The use of an address.

      Typecode
      Is Modifiertrue because This is labeled as "Is Modifier" because applications should not mistake a temporary or old address etc.for a current/permanent one
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summarytrue
      Requirements

      Allows an appropriate address to be chosen from a list of many.

      Example<br/><b>General</b>:home
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      34. Practitioner.address.line
      Definition

      This component contains the house number, apartment number, street name, street direction, P.O. Box number, delivery hints, and similar address information.

      ShortStreet name, number, direction & P.O. Box etc.
      Control0..4*
      Typestring
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Must Supporttrue
      Summarytrue
      Example<br/><b>General</b>:137 Nowhere Street <br/><b>General</b>:49 MEADOW ST
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      36. Practitioner.address.city
      Definition

      The name of the city, town, suburb, village or other community or delivery center.

      ShortName of city, town etc.
      Control0..1
      Typestring
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Must Supporttrue
      Summarytrue
      Alternate NamesMunicpality
      Example<br/><b>General</b>:Erewhon <br/><b>General</b>:EVERYTOWN
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      38. Practitioner.address.state
      Definition

      Sub-unit of a country with limited sovereignty in a federally organized country. A code may be used if codes are in common use (e.g. US 2 letter state codes).

      ShortSub-unit of country (abbreviations ok)
      Control0..1
      BindingUnless not suitable, these codes SHALL be taken from For codes, see USPS Two Letter Alphabetic Codes
      (extensible to http://hl7.org/fhir/us/core/ValueSet/us-core-usps-state)

      Two letter USPS alphabetic codes.

      Typestring
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Must Supporttrue
      Summarytrue
      Alternate NamesProvince, Territory
      Example<br/><b>General</b>:OK
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      40. Practitioner.address.postalCode
      Definition

      A postal code designating a region defined by the postal service.

      ShortUS Zip CodesPostal code for area
      Control0..1
      Typestring
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Must Supporttrue
      Summarytrue
      Alternate NamesZip
      Example<br/><b>General</b>:9132 <br/><b>General</b>:74047
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      42. Practitioner.address.country
      Definition

      Country - a nation as commonly understood or generally accepted.

      ShortCountry (e.g. can be ISO 3166 2 or 3 letter code)
      Comments

      ISO 3166 3 letter codes can be used in place of a human readable country name.

      Control0..1
      Typestring
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Must Supporttrue
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

      Guidance on how to interpret the contents of this table can be found here

      0. Practitioner
      Definition

      A person who is directly or indirectly involved in the provisioning of healthcare.

      ShortA person with a formal responsibility in the provisioning of healthcare or related services
      Control0..*
      Is Modifierfalse
      Must Supportfalse
      Summaryfalse
      Alternate NamesProvider
      Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
      dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty())
      dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
      dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
      dom-6: A resource should have narrative for robust management (text.`div`.exists())
      2. Practitioner.id
      Definition

      The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

      ShortLogical id of this artifact
      Comments

      The only time that a resource does not have an id is when it is being submitted to the server using a create operation.

      Control0..1
      Typeid
      Is Modifierfalse
      Summarytrue
      4. Practitioner.meta
      Definition

      The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.

      ShortMetadata about the resource
      Control0..1
      TypeMeta
      Is Modifierfalse
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      6. Practitioner.implicitRules
      Definition

      A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

      ShortA set of rules under which this content was created
      Comments

      Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

      Control0..1
      Typeuri
      Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      8. Practitioner.language
      Definition

      The base language in which the resource is written.

      ShortLanguage of the resource content
      Comments

      Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).

      Control0..1
      BindingThe codes SHOULD be taken from CommonLanguages
      (preferred to http://hl7.org/fhir/ValueSet/languages)

      A human language.

      Additional BindingsPurpose
      AllLanguagesMax Binding
      Typecode
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      10. Practitioner.text
      Definition

      A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.

      ShortText summary of the resource, for human interpretation
      Comments

      Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later.

      Control0..1
      TypeNarrative
      Is Modifierfalse
      Summaryfalse
      Alternate Namesnarrative, html, xhtml, display
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      12. Practitioner.contained
      Definition

      These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.

      ShortContained, inline Resources
      Comments

      This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.

      Control0..*
      TypeResource
      Is Modifierfalse
      Summaryfalse
      Alternate Namesinline resources, anonymous resources, contained resources
      14. Practitioner.extension
      Definition

      May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

      ShortAdditional content defined by implementations
      Comments

      There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

      Control0..*
      TypeExtension
      Is Modifierfalse
      Summaryfalse
      Alternate Namesextensions, user content
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      16. Practitioner.modifierExtension
      Definition

      May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

      Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

      ShortExtensions that cannot be ignored
      Comments

      There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

      Control0..*
      TypeExtension
      Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
      Summaryfalse
      Requirements

      Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

      Alternate Namesextensions, user content
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      18. Practitioner.identifier
      Definition

      An identifier that applies to this person in this role.

      ShortAn identifier for the person as this agent
      Comments

      NPI must be supported as the identifier system in the US, Tax id is allowed, Local id is allowed in addition to another identifier supplied by a jurisdictional authority such as a practitioner's Drug Enforcement Administration (DEA) number.

      NoteThis is a business identifier, not a resource identifier (see discussion)
      Control1..*
      TypeIdentifier
      Is Modifierfalse
      Must Supporttrue
      Summarytrue
      Requirements

      Often, specific identities are assigned for the agent.

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      SlicingThis element introduces a set of slices on Practitioner.identifier. The slices are unordered and Open, and can be differentiated using the following discriminators:
      • pattern @ $this
      • 20. Practitioner.identifier.id
        Definition

        Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

        ShortUnique id for inter-element referencing
        Control0..1
        Typestring
        Is Modifierfalse
        XML FormatIn the XML format, this property is represented as an attribute.
        Summaryfalse
        22. Practitioner.identifier.extension
        Definition

        May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

        ShortAdditional content defined by implementations
        Comments

        There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

        Control0..*
        TypeExtension
        Is Modifierfalse
        Summaryfalse
        Alternate Namesextensions, user content
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        SlicingThis element introduces a set of slices on Practitioner.identifier.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
        • value @ url
        • 24. Practitioner.identifier.use
          Definition

          The purpose of this identifier.

          Shortusual | official | temp | secondary | old (If known)
          Comments

          Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

          Control0..1
          BindingThe codes SHALL be taken from IdentifierUse
          (required to http://hl7.org/fhir/ValueSet/identifier-use|4.0.1)

          Identifies the purpose for this identifier, if known .

          Typecode
          Is Modifiertrue because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summarytrue
          Requirements

          Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          26. Practitioner.identifier.type
          Definition

          A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.

          ShortDescription of identifier
          Comments

          This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.

          Control0..1
          BindingUnless not suitable, these codes SHALL be taken from Identifier Type Codes
          (extensible to http://hl7.org/fhir/ValueSet/identifier-type)

          A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

          TypeCodeableConcept
          Is Modifierfalse
          Summarytrue
          Requirements

          Allows users to make use of identifiers when the identifier system is not known.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          28. Practitioner.identifier.system
          Definition

          Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

          ShortThe namespace for the identifier value
          Comments

          Identifier.system is always case sensitive.

          Control1..1
          Typeuri
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supporttrue
          Summarytrue
          Requirements

          There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

          Example<br/><b>General</b>:http://www.acme.com/identifiers/patient
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          30. Practitioner.identifier.value
          Definition

          The portion of the identifier typically relevant to the user and which is unique within the context of the system.

          ShortThe value that is unique
          Comments

          If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.

          Control1..1
          Typestring
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supporttrue
          Summarytrue
          Example<br/><b>General</b>:123456
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          32. Practitioner.identifier.period
          Definition

          Time period during which identifier is/was valid for use.

          ShortTime period when id is/was valid for use
          Control0..1
          TypePeriod
          Is Modifierfalse
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          34. Practitioner.identifier.assigner
          Definition

          Organization that issued/manages the identifier.

          ShortOrganization that issued id (may be just text)
          Comments

          The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.

          Control0..1
          TypeReference(Organization)
          Is Modifierfalse
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          36. Practitioner.identifier:NPI
          Slice NameNPI
          Definition

          An identifier that applies to this person in this role.

          ShortAn identifier for the person as this agent
          NoteThis is a business identifier, not a resource identifier (see discussion)
          Control0..*
          This element is affected by the following invariants: us-core-16, us-core-17
          TypeIdentifier
          Is Modifierfalse
          Must Supporttrue
          Summarytrue
          Requirements

          Often, specific identities are assigned for the agent.

          Pattern Value{
            "system" : "http://hl7.org/fhir/sid/us-npi"
          }
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          us-core-16: NPI must be 10 digits (value.matches('^[0-9]{10}$'))
          us-core-17: NPI check digit must be valid (Luhn algorithm check) ((((select(value.substring(0,1).toInteger()).select(iif($this<5, $this*2, (($this*2)-9))))+(value.substring(1,1).toInteger())+(select(value.substring(2,1).toInteger()).select(iif($this<5, $this*2, (($this*2)-9))))+(value.substring(3,1).toInteger())+(select(value.substring(4,1).toInteger()).select(iif($this<5, $this*2, (($this*2)-9))))+(value.substring(5,1).toInteger())+(select(value.substring(6,1).toInteger()).select(iif($this<5, $this*2, (($this*2)-9))))+(value.substring(7,1).toInteger())+(select(value.substring(8,1).toInteger()).select(iif($this<5, $this*2, (($this*2)-9))))+(value.substring(9,1).toInteger()) + 24)mod 10=0))
          38. Practitioner.active
          Definition

          Whether this practitioner's record is in active use.

          ShortWhether this practitioner's record is in active use
          Comments

          If the practitioner is not in use by one organization, then it should mark the period on the PractitonerRole with an end date (even if they are active) as they may be active in another role.

          Control0..1
          Typeboolean
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summarytrue
          Requirements

          Need to be able to mark a practitioner record as not to be used because it was created in error.

          Meaning if MissingThis resource is generally assumed to be active if no value is provided for the active element
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          40. Practitioner.name
          Definition

          The name(s) associated with the practitioner.

          ShortThe name(s) associated with the practitioner
          Comments

          The selection of the use property should ensure that there is a single usual name specified, and others use the nickname (alias), old, or other values as appropriate.

          In general, select the value to be used in the ResourceReference.display based on this:

          1. There is more than 1 name
          2. Use = usual
          3. Period is current to the date of the usage
          4. Use = official
          5. Other order as decided by internal business rules.
          Control1..*
          TypeHumanName
          Is Modifierfalse
          Must Supporttrue
          Summarytrue
          Requirements

          The name(s) that a Practitioner is known by. Where there are multiple, the name that the practitioner is usually known as should be used in the display.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          42. Practitioner.name.id
          Definition

          Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

          ShortUnique id for inter-element referencing
          Control0..1
          Typestring
          Is Modifierfalse
          XML FormatIn the XML format, this property is represented as an attribute.
          Summaryfalse
          44. Practitioner.name.extension
          Definition

          May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

          ShortAdditional content defined by implementations
          Comments

          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

          Control0..*
          TypeExtension
          Is Modifierfalse
          Summaryfalse
          Alternate Namesextensions, user content
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          SlicingThis element introduces a set of slices on Practitioner.name.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
          • value @ url
          • 46. Practitioner.name.use
            Definition

            Identifies the purpose for this name.

            Shortusual | official | temp | nickname | anonymous | old | maiden
            Comments

            Applications can assume that a name is current unless it explicitly says that it is temporary or old.

            Control0..1
            BindingThe codes SHALL be taken from NameUse
            (required to http://hl7.org/fhir/ValueSet/name-use|4.0.1)

            The use of a human name.

            Typecode
            Is Modifiertrue because This is labeled as "Is Modifier" because applications should not mistake a temporary or old name etc.for a current/permanent one
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Summarytrue
            Requirements

            Allows the appropriate name for a particular context of use to be selected from among a set of names.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            48. Practitioner.name.text
            Definition

            Specifies the entire name as it should be displayed e.g. on an application UI. This may be provided instead of or as well as the specific parts.

            ShortText representation of the full name
            Comments

            Can provide both a text representation and parts. Applications updating a name SHALL ensure that when both text and parts are present, no content is included in the text that isn't found in a part.

            Control0..1
            Typestring
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Summarytrue
            Requirements

            A renderable, unencoded form.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            50. Practitioner.name.family
            Definition

            The part of a name that links to the genealogy. In some cultures (e.g. Eritrea) the family name of a son is the first name of his father.

            ShortFamily name (often called 'Surname')
            Comments

            Family Name may be decomposed into specific parts using extensions (de, nl, es related cultures).

            Control1..1
            Typestring
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Must Supporttrue
            Summarytrue
            Alternate Namessurname
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            52. Practitioner.name.given
            Definition

            Given name.

            ShortGiven names (not always 'first'). Includes middle names
            Comments

            If only initials are recorded, they may be used in place of the full name parts. Initials may be separated into multiple given names but often aren't due to paractical limitations. This element is not called "first name" since given names do not always come first.

            Control0..*
            Typestring
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Summarytrue
            Alternate Namesfirst name, middle name
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            54. Practitioner.name.prefix
            Definition

            Part of the name that is acquired as a title due to academic, legal, employment or nobility status, etc. and that appears at the start of the name.

            ShortParts that come before the name
            Control0..*
            Typestring
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            56. Practitioner.name.suffix
            Definition

            Part of the name that is acquired as a title due to academic, legal, employment or nobility status, etc. and that appears at the end of the name.

            ShortParts that come after the name
            Control0..*
            Typestring
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            58. Practitioner.name.period
            Definition

            Indicates the period of time when this name was valid for the named person.

            ShortTime period when name was/is in use
            Control0..1
            TypePeriod
            Is Modifierfalse
            Summarytrue
            Requirements

            Allows names to be placed in historical context.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            60. Practitioner.telecom
            Definition

            A contact detail for the practitioner, e.g. a telephone number or an email address.

            ShortA contact detail for the practitioner (that apply to all roles)
            Comments

            Person may have multiple ways to be contacted with different uses or applicable periods. May need to have options for contacting the person urgently and to help with identification. These typically will have home numbers, or mobile numbers that are not role specific.

            Control0..*
            TypeContactPoint
            Is Modifierfalse
            Must Supporttrue
            Summarytrue
            Requirements

            Need to know how to reach a practitioner independent to any roles the practitioner may have.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            62. Practitioner.telecom.id
            Definition

            Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

            ShortUnique id for inter-element referencing
            Control0..1
            Typestring
            Is Modifierfalse
            XML FormatIn the XML format, this property is represented as an attribute.
            Summaryfalse
            64. Practitioner.telecom.extension
            Definition

            May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

            ShortAdditional content defined by implementations
            Comments

            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

            Control0..*
            TypeExtension
            Is Modifierfalse
            Summaryfalse
            Alternate Namesextensions, user content
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            SlicingThis element introduces a set of slices on Practitioner.telecom.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
            • value @ url
            • 66. Practitioner.telecom.system
              Definition

              Telecommunications form for contact point - what communications system is required to make use of the contact.

              Shortphone | fax | email | pager | url | sms | other
              Control0..1
              This element is affected by the following invariants: cpt-2
              BindingThe codes SHALL be taken from ContactPointSystem
              (required to http://hl7.org/fhir/ValueSet/contact-point-system|4.0.1)

              Telecommunications form for contact point.

              Typecode
              Is Modifierfalse
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Must Supporttrue
              Summarytrue
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              68. Practitioner.telecom.value
              Definition

              The actual contact point details, in a form that is meaningful to the designated communication system (i.e. phone number or email address).

              ShortThe actual contact point details
              Comments

              Additional text data such as phone extension numbers, or notes about use of the contact are sometimes included in the value.

              Control0..1
              Typestring
              Is Modifierfalse
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Must Supporttrue
              Summarytrue
              Requirements

              Need to support legacy numbers that are not in a tightly controlled format.

              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              70. Practitioner.telecom.use
              Definition

              Identifies the purpose for the contact point.

              Shorthome | work | temp | old | mobile - purpose of this contact point
              Comments

              Applications can assume that a contact is current unless it explicitly says that it is temporary or old.

              Control0..1
              BindingThe codes SHALL be taken from ContactPointUse
              (required to http://hl7.org/fhir/ValueSet/contact-point-use|4.0.1)

              Use of contact point.

              Typecode
              Is Modifiertrue because This is labeled as "Is Modifier" because applications should not mistake a temporary or old contact etc.for a current/permanent one
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Summarytrue
              Requirements

              Need to track the way a person uses this contact, so a user can choose which is appropriate for their purpose.

              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              72. Practitioner.telecom.rank
              Definition

              Specifies a preferred order in which to use a set of contacts. ContactPoints with lower rank values are more preferred than those with higher rank values.

              ShortSpecify preferred order of use (1 = highest)
              Comments

              Note that rank does not necessarily follow the order in which the contacts are represented in the instance.

              Control0..1
              TypepositiveInt
              Is Modifierfalse
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Summarytrue
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              74. Practitioner.telecom.period
              Definition

              Time period when the contact point was/is in use.

              ShortTime period when the contact point was/is in use
              Control0..1
              TypePeriod
              Is Modifierfalse
              Summarytrue
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              76. Practitioner.address
              Definition

              Address(es) of the practitioner

              ShortAddress(es) of the practitioner
              Comments

              The PractitionerRole does not have an address value on it, as it is expected that the location property be used for this purpose (which has an address).

              Control0..*
              TypeAddress
              Is Modifierfalse
              Must Supporttrue
              Summarytrue
              Requirements

              -

              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              78. Practitioner.address.id
              Definition

              Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

              ShortUnique id for inter-element referencing
              Control0..1
              Typestring
              Is Modifierfalse
              XML FormatIn the XML format, this property is represented as an attribute.
              Summaryfalse
              80. Practitioner.address.extension
              Definition

              May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

              ShortAdditional content defined by implementations
              Comments

              There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

              Control0..*
              TypeExtension
              Is Modifierfalse
              Summaryfalse
              Alternate Namesextensions, user content
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
              SlicingThis element introduces a set of slices on Practitioner.address.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
              • value @ url
              • 82. Practitioner.address.use
                Definition

                The purpose of this address.

                Shorthome | work | temp | old | billing - purpose of this address
                Comments

                Applications can assume that an address is current unless it explicitly says that it is temporary or old.

                Control0..1
                BindingThe codes SHALL be taken from AddressUse
                (required to http://hl7.org/fhir/ValueSet/address-use|4.0.1)

                The use of an address.

                Typecode
                Is Modifiertrue because This is labeled as "Is Modifier" because applications should not mistake a temporary or old address etc.for a current/permanent one
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Summarytrue
                Requirements

                Allows an appropriate address to be chosen from a list of many.

                Example<br/><b>General</b>:home
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                84. Practitioner.address.type
                Definition

                Distinguishes between physical addresses (those you can visit) and mailing addresses (e.g. PO Boxes and care-of addresses). Most addresses are both.

                Shortpostal | physical | both
                Comments

                The definition of Address states that "address is intended to describe postal addresses, not physical locations". However, many applications track whether an address has a dual purpose of being a location that can be visited as well as being a valid delivery destination, and Postal addresses are often used as proxies for physical locations (also see the Location resource).

                Control0..1
                BindingThe codes SHALL be taken from AddressType
                (required to http://hl7.org/fhir/ValueSet/address-type|4.0.1)

                The type of an address (physical / postal).

                Typecode
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Summarytrue
                Example<br/><b>General</b>:both
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                86. Practitioner.address.text
                Definition

                Specifies the entire address as it should be displayed e.g. on a postal label. This may be provided instead of or as well as the specific parts.

                ShortText representation of the address
                Comments

                Can provide both a text representation and parts. Applications updating an address SHALL ensure that when both text and parts are present, no content is included in the text that isn't found in a part.

                Control0..1
                Typestring
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Summarytrue
                Requirements

                A renderable, unencoded form.

                Example<br/><b>General</b>:137 Nowhere Street, Erewhon 9132
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                88. Practitioner.address.line
                Definition

                This component contains the house number, apartment number, street name, street direction, P.O. Box number, delivery hints, and similar address information.

                ShortStreet name, number, direction & P.O. Box etc.
                Control0..4
                Typestring
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Must Supporttrue
                Summarytrue
                Example<br/><b>General</b>:137 Nowhere Street <br/><b>General</b>:49 MEADOW ST
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                90. Practitioner.address.city
                Definition

                The name of the city, town, suburb, village or other community or delivery center.

                ShortName of city, town etc.
                Control0..1
                Typestring
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Must Supporttrue
                Summarytrue
                Alternate NamesMunicpality
                Example<br/><b>General</b>:Erewhon <br/><b>General</b>:EVERYTOWN
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                92. Practitioner.address.district
                Definition

                The name of the administrative area (county).

                ShortDistrict name (aka county)
                Comments

                District is sometimes known as county, but in some regions 'county' is used in place of city (municipality), so county name should be conveyed in city instead.

                Control0..1
                Typestring
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Summarytrue
                Alternate NamesCounty
                Example<br/><b>General</b>:Madison
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                94. Practitioner.address.state
                Definition

                Sub-unit of a country with limited sovereignty in a federally organized country. A code may be used if codes are in common use (e.g. US 2 letter state codes).

                ShortSub-unit of country (abbreviations ok)
                Control0..1
                BindingUnless not suitable, these codes SHALL be taken from USPS Two Letter Alphabetic Codes
                (extensible to http://hl7.org/fhir/us/core/ValueSet/us-core-usps-state)

                Two letter USPS alphabetic codes.

                Typestring
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Must Supporttrue
                Summarytrue
                Alternate NamesProvince, Territory
                Example<br/><b>General</b>:OK
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                96. Practitioner.address.postalCode
                Definition

                A postal code designating a region defined by the postal service.

                ShortUS Zip Codes
                Control0..1
                Typestring
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Must Supporttrue
                Summarytrue
                Alternate NamesZip
                Example<br/><b>General</b>:9132 <br/><b>General</b>:74047
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                98. Practitioner.address.country
                Definition

                Country - a nation as commonly understood or generally accepted.

                ShortCountry (e.g. can be ISO 3166 2 or 3 letter code)
                Comments

                ISO 3166 3 letter codes can be used in place of a human readable country name.

                Control0..1
                Typestring
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Must Supporttrue
                Summarytrue
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                100. Practitioner.address.period
                Definition

                Time period when address was/is in use.

                ShortTime period when address was/is in use
                Control0..1
                TypePeriod
                Is Modifierfalse
                Summarytrue
                Requirements

                Allows addresses to be placed in historical context.

                Example<br/><b>General</b>:{ "start" : "2010-03-23", "end" : "2010-07-01" }
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                102. Practitioner.gender
                Definition

                Administrative Gender - the gender that the person is considered to have for administration and record keeping purposes.

                Shortmale | female | other | unknown
                Control0..1
                BindingThe codes SHALL be taken from AdministrativeGender
                (required to http://hl7.org/fhir/ValueSet/administrative-gender|4.0.1)

                The gender of a person used for administrative purposes.

                Typecode
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Summarytrue
                Requirements

                Needed to address the person correctly.

                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                104. Practitioner.birthDate
                Definition

                The date of birth for the practitioner.

                ShortThe date on which the practitioner was born
                Control0..1
                Typedate
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Summarytrue
                Requirements

                Needed for identification.

                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                106. Practitioner.photo
                Definition

                Image of the person.

                ShortImage of the person
                Control0..*
                TypeAttachment
                Is Modifierfalse
                Summaryfalse
                Requirements

                Many EHR systems have the capability to capture an image of patients and personnel. Fits with newer social media usage too.

                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                108. Practitioner.qualification
                Definition

                The official certifications, training, and licenses that authorize or otherwise pertain to the provision of care by the practitioner. For example, a medical license issued by a medical board authorizing the practitioner to practice medicine within a certian locality.

                ShortCertification, licenses, or training pertaining to the provision of care
                Control0..*
                TypeBackboneElement
                Is Modifierfalse
                Summaryfalse
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                110. Practitioner.qualification.id
                Definition

                Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                ShortUnique id for inter-element referencing
                Control0..1
                Typestring
                Is Modifierfalse
                XML FormatIn the XML format, this property is represented as an attribute.
                Summaryfalse
                112. Practitioner.qualification.extension
                Definition

                May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                ShortAdditional content defined by implementations
                Comments

                There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                Control0..*
                TypeExtension
                Is Modifierfalse
                Summaryfalse
                Alternate Namesextensions, user content
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                114. Practitioner.qualification.modifierExtension
                Definition

                May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                ShortExtensions that cannot be ignored even if unrecognized
                Comments

                There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                Control0..*
                TypeExtension
                Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                Summarytrue
                Requirements

                Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                Alternate Namesextensions, user content, modifiers
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                116. Practitioner.qualification.identifier
                Definition

                An identifier that applies to this person's qualification in this role.

                ShortAn identifier for this qualification for the practitioner
                NoteThis is a business identifier, not a resource identifier (see discussion)
                Control0..*
                TypeIdentifier
                Is Modifierfalse
                Summaryfalse
                Requirements

                Often, specific identities are assigned for the qualification.

                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                118. Practitioner.qualification.code
                Definition

                Coded representation of the qualification.

                ShortCoded representation of the qualification
                Control1..1
                BindingFor example codes, see v2 table 0360, Version 2.7
                (example to http://terminology.hl7.org/ValueSet/v2-2.7-0360)

                Specific qualification the practitioner has to provide a service.

                TypeCodeableConcept
                Is Modifierfalse
                Summaryfalse
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                120. Practitioner.qualification.period
                Definition

                Period during which the qualification is valid.

                ShortPeriod during which the qualification is valid
                Control0..1
                TypePeriod
                Is Modifierfalse
                Summaryfalse
                Requirements

                Qualifications are often for a limited period of time, and can be revoked.

                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                122. Practitioner.qualification.issuer
                Definition

                Organization that regulates and issues the qualification.

                ShortOrganization that regulates and issues the qualification
                Control0..1
                TypeReference(Organization)
                Is Modifierfalse
                Summaryfalse
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                124. Practitioner.communication
                Definition

                A language the practitioner can use in patient communication.

                ShortA language the practitioner can use in patient communication
                Comments

                The structure aa-BB with this exact casing is one the most widely used notations for locale. However not all systems code this but instead have it as free text. Hence CodeableConcept instead of code as the data type.

                Control0..*
                BindingThe codes SHOULD be taken from CommonLanguages
                (preferred to http://hl7.org/fhir/ValueSet/languages)

                A human language.

                Additional BindingsPurpose
                AllLanguagesMax Binding
                TypeCodeableConcept
                Is Modifierfalse
                Summaryfalse
                Requirements

                Knowing which language a practitioner speaks can help in facilitating communication with patients.

                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))