CARIN Consumer Directed Payer Data Exchange (CARIN IG for Blue Button®)
2.1.0-snapshot1 - STU 2.1 prepublication draft United States of America flag

CARIN Consumer Directed Payer Data Exchange (CARIN IG for Blue Button®), published by HL7 International / Financial Management. This guide is not an authorized publication; it is the continuous build for version 2.1.0-snapshot1 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/carin-bb/ and changes regularly. See the Directory of published versions

Resource Profile: C4BB Practitioner

Official URL: http://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-Practitioner Version: 2.1.0-snapshot1
Standards status: Trial-use Computable Name: C4BBPractitioner

This profile builds upon the US Core Practitioner profile. It is used to convey information about the practitioner who provided to the patient services described on the claim.

Notes on Fields

  • The Practitioner FHIR Resource defines a comprehensive set of data elements.  Many of them are not relevant to this use case.  When reviewing the Profile Snapshot, several data elements previously hidden are now exposed.  Fields intended for consideration to be provided in the API are marked as Must Support; i.e., a red S or have a minimum cardinality of 1.  All other data elements are not expected to be sent by a Responder; if they are sent a Requestor can choose to ignore them
  • Payers may decide to provide either the data that was in effect as of the date of service or the current data.
  • .identifier[NPI], .identifier[tax]: One of these identifiers must be provided
  • .meta.lastUpdated: Payers SHALL provide the last time the data was updated or the date of creation in the payer’s system of record, whichever comes last. Apps will use the meta.lastUpdated value to determine if the Reference resources are as of the current date or date of service.
  • The CPCDS data elements are defined in the data element comments.  The numbers, e.g. (1), following the data element descriptions in the comments correlate to the MapID in the CPCDS Data Dictionary and the Mapping Worksheet as described here.
  • meta.profile is required as a matter of convenience of receiving systems. The meta.profile should be used by the Server to hint/assert/declare that this instance conforms to one (or more) stated profiles (with business versions). meta.profile does not capture any business logic, processing directives, or semantics (for example, inpatient or outpatient). Clients should not assume that the Server will exhaustively indicate all profiles with all versions that this instance conforms to. Clients can (and should) perform their own validation of conformance to the indicated profile(s) and to any other profiles of interest.

Usage:

Formal Views of Profile Content

Description of Profiles, Differentials, Snapshots and how the different presentations work.

This structure is derived from USCorePractitionerProfile

NameFlagsCard.TypeDescription & Constraintsdoco
.. Practitioner C 0..* USCorePractitionerProfile(6.1.0) A person with a formal responsibility in the provisioning of healthcare or related services
This profile also complies with the profile US Core Practitioner Profile (3.1.1)
Practitioner-identifier: Practitioner.identifier must include an NPI or a Tax ID
practitioner-meta-profile-version: Practitioner: meta.profile with canonical and major.minor. version required.
... meta S 1..1 Meta Metadata about the resource
.... lastUpdated S 0..1 instant When the resource version last changed
.... profile 1..* canonical(StructureDefinition) Profiles this resource claims to conform to
... Slices for identifier Content/Rules for all slices
.... identifier:NPI 0..1 Identifier National Provider Identifier
Required Pattern: At least the following
..... type 1..1 CodeableConcept Description of identifier
Fixed Value: (complex)
...... coding 1..* Coding Code defined by a terminology system
Fixed Value: (complex)
....... system 1..1 uri Identity of the terminology system
Fixed Value: http://terminology.hl7.org/CodeSystem/v2-0203
....... code 1..1 code Symbol in syntax defined by the system
Fixed Value: NPI
..... system 1..1 uri The namespace for the identifier value
Fixed Value: http://hl7.org/fhir/sid/us-npi
.... identifier:tax S 0..* Identifier Tax ID Number

Required Pattern: At least the following
..... type 1..1 CodeableConcept Description of identifier
Fixed Value: (complex)
...... coding 1..* Coding Code defined by a terminology system
Fixed Value: (complex)
....... system 1..1 uri Identity of the terminology system
Fixed Value: http://terminology.hl7.org/CodeSystem/v2-0203
....... code 1..1 code Symbol in syntax defined by the system
Fixed Value: TAX
..... system 1..1 uri The namespace for the identifier value
Fixed Value: urn:oid:2.16.840.1.113883.4.4
... name 1..* HumanName The name(s) associated with the practitioner

doco Documentation for this format

Constraints

IdGradePath(s)DetailsRequirements
Practitioner-identifiererrorPractitionerPractitioner.identifier must include an NPI or a Tax ID
: identifier.where(type.where(coding.where(code in ('NPI' | 'TAX')).exists()).exists()).exists()
practitioner-meta-profile-versionwarningPractitionerPractitioner: meta.profile with canonical and major.minor. version required.
: meta.profile.exists($this.startsWith('http://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-Practitioner|2.1'))
NameFlagsCard.TypeDescription & Constraintsdoco
.. Practitioner C 0..* USCorePractitionerProfile(6.1.0) A person with a formal responsibility in the provisioning of healthcare or related services
This profile also complies with the profile US Core Practitioner Profile (3.1.1)
Practitioner-identifier: Practitioner.identifier must include an NPI or a Tax ID
practitioner-meta-profile-version: Practitioner: meta.profile with canonical and major.minor. version required.
... meta SΣ 1..1 Meta Metadata about the resource
.... lastUpdated SΣ 0..1 instant When the resource version last changed
.... profile Σ 1..* canonical(StructureDefinition) Profiles this resource claims to conform to
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
.... identifier:NPI SΣC 0..1 Identifier National Provider Identifier
us-core-16: NPI must be 10 digits
us-core-17: NPI check digit must be valid (Luhn algorithm check)

Required Pattern: At least the following
..... type 1..1 CodeableConcept Description of identifier
Fixed Value: (complex)
...... coding 1..* Coding Code defined by a terminology system
Fixed Value: (complex)
....... system 1..1 uri Identity of the terminology system
Fixed Value: http://terminology.hl7.org/CodeSystem/v2-0203
....... code 1..1 code Symbol in syntax defined by the system
Fixed Value: NPI
..... system 1..1 uri The namespace for the identifier value
Fixed Value: http://hl7.org/fhir/sid/us-npi
.... identifier:tax SΣ 0..* Identifier Tax ID Number

Required Pattern: At least the following
..... type 1..1 CodeableConcept Description of identifier
Fixed Value: (complex)
...... coding 1..* Coding Code defined by a terminology system
Fixed Value: (complex)
....... system 1..1 uri Identity of the terminology system
Fixed Value: http://terminology.hl7.org/CodeSystem/v2-0203
....... code 1..1 code Symbol in syntax defined by the system
Fixed Value: TAX
..... system 1..1 uri The namespace for the identifier value
Fixed Value: urn:oid:2.16.840.1.113883.4.4
... name SΣ 1..* HumanName The name(s) associated with the practitioner
.... use ?!Σ 0..1 code usual | official | temp | nickname | anonymous | old | maiden
Binding: NameUse (required): The use of a human name.

.... family SΣ 1..1 string Family name (often called 'Surname')
... telecom SΣ 0..* ContactPoint A contact detail for the practitioner (that apply to all roles)
.... system SΣC 0..1 code phone | fax | email | pager | url | sms | other
Binding: ContactPointSystem (required): Telecommunications form for contact point.

.... value SΣ 0..1 string The actual contact point details
.... use ?!Σ 0..1 code home | work | temp | old | mobile - purpose of this contact point
Binding: ContactPointUse (required): Use of contact point.

... address SΣ 0..* Address Address(es) of the practitioner
.... use ?!Σ 0..1 code home | work | temp | old | billing - purpose of this address
Binding: AddressUse (required): The use of an address.


Example General: home
.... line SΣ 0..4 string Street name, number, direction & P.O. Box etc.
This repeating element order: The order in which lines should appear in an address label
Example General: 137 Nowhere Street
.... city SΣ 0..1 string Name of city, town etc.
Example General: Erewhon
.... state SΣ 0..1 string Sub-unit of country (abbreviations ok)
Binding: USPS Two Letter Alphabetic Codes (extensible): Two letter USPS alphabetic codes.

.... postalCode SΣ 0..1 string US Zip Codes
Example General: 9132
.... country SΣ 0..1 string Country (e.g. can be ISO 3166 2 or 3 letter code)

doco Documentation for this format

Terminology Bindings

PathConformanceValueSetURI
Practitioner.name.userequiredNameUse
http://hl7.org/fhir/ValueSet/name-use|4.0.1
from the FHIR Standard
Practitioner.telecom.systemrequiredContactPointSystem
http://hl7.org/fhir/ValueSet/contact-point-system|4.0.1
from the FHIR Standard
Practitioner.telecom.userequiredContactPointUse
http://hl7.org/fhir/ValueSet/contact-point-use|4.0.1
from the FHIR Standard
Practitioner.address.userequiredAddressUse
http://hl7.org/fhir/ValueSet/address-use|4.0.1
from the FHIR Standard
Practitioner.address.stateextensibleUspsTwoLetterAlphabeticCodes (a valid code from https://www.usps.com/)
http://hl7.org/fhir/us/core/ValueSet/us-core-usps-state

Constraints

IdGradePath(s)DetailsRequirements
Practitioner-identifiererrorPractitionerPractitioner.identifier must include an NPI or a Tax ID
: identifier.where(type.where(coding.where(code in ('NPI' | 'TAX')).exists()).exists()).exists()
practitioner-meta-profile-versionwarningPractitionerPractitioner: meta.profile with canonical and major.minor. version required.
: meta.profile.exists($this.startsWith('http://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-Practitioner|2.1'))
NameFlagsCard.TypeDescription & Constraintsdoco
.. Practitioner C 0..* USCorePractitionerProfile(6.1.0) A person with a formal responsibility in the provisioning of healthcare or related services
This profile also complies with the profile US Core Practitioner Profile (3.1.1)
Practitioner-identifier: Practitioner.identifier must include an NPI or a Tax ID
practitioner-meta-profile-version: Practitioner: meta.profile with canonical and major.minor. version required.
... id Σ 0..1 id Logical id of this artifact
... meta SΣ 1..1 Meta Metadata about the resource
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... versionId Σ 0..1 id Version specific identifier
.... lastUpdated SΣ 0..1 instant When the resource version last changed
.... source Σ 0..1 uri Identifies where the resource comes from
.... profile Σ 1..* canonical(StructureDefinition) Profiles this resource claims to conform to
.... security Σ 0..* Coding Security Labels applied to this resource
Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.


.... tag Σ 0..* Coding Tags applied to this resource
Binding: CommonTags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".


... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... text 0..1 Narrative Text summary of the resource, for human interpretation
... contained 0..* Resource Contained, inline Resources
... extension 0..* Extension Additional content defined by implementations
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... Slices for identifier SΣ 1..* Identifier An identifier for the person as this agent
Slice: Unordered, Open by pattern:$this
.... identifier:NPI SΣC 0..1 Identifier National Provider Identifier
us-core-16: NPI must be 10 digits
us-core-17: NPI check digit must be valid (Luhn algorithm check)

Required Pattern: At least the following
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
..... use 0..1 code usual | official | temp | secondary | old (If known)
..... type 1..1 CodeableConcept Description of identifier
Fixed Value: (complex)
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
...... coding 1..* Coding Code defined by a terminology system
Fixed Value: (complex)
....... id 0..1 string Unique id for inter-element referencing
....... extension 0..* Extension Additional content defined by implementations
....... system 1..1 uri Identity of the terminology system
Fixed Value: http://terminology.hl7.org/CodeSystem/v2-0203
....... version 0..1 string Version of the system - if relevant
....... code 1..1 code Symbol in syntax defined by the system
Fixed Value: NPI
....... display 0..1 string Representation defined by the system
....... userSelected 0..1 boolean If this coding was chosen directly by the user
...... text 0..1 string Plain text representation of the concept
..... system 1..1 uri The namespace for the identifier value
Fixed Value: http://hl7.org/fhir/sid/us-npi
..... value 0..1 string The value that is unique
..... period 0..1 Period Time period when id is/was valid for use
..... assigner 0..1 Reference(Organization) Organization that issued id (may be just text)
.... identifier:tax SΣ 0..* Identifier Tax ID Number

Required Pattern: At least the following
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
..... use 0..1 code usual | official | temp | secondary | old (If known)
..... type 1..1 CodeableConcept Description of identifier
Fixed Value: (complex)
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
...... coding 1..* Coding Code defined by a terminology system
Fixed Value: (complex)
....... id 0..1 string Unique id for inter-element referencing
....... extension 0..* Extension Additional content defined by implementations
....... system 1..1 uri Identity of the terminology system
Fixed Value: http://terminology.hl7.org/CodeSystem/v2-0203
....... version 0..1 string Version of the system - if relevant
....... code 1..1 code Symbol in syntax defined by the system
Fixed Value: TAX
....... display 0..1 string Representation defined by the system
....... userSelected 0..1 boolean If this coding was chosen directly by the user
...... text 0..1 string Plain text representation of the concept
..... system 1..1 uri The namespace for the identifier value
Fixed Value: urn:oid:2.16.840.1.113883.4.4
..... value 0..1 string The value that is unique
..... period 0..1 Period Time period when id is/was valid for use
..... assigner 0..1 Reference(Organization) Organization that issued id (may be just text)
... active Σ 0..1 boolean Whether this practitioner's record is in active use
... name SΣ 1..* HumanName The name(s) associated with the practitioner
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... use ?!Σ 0..1 code usual | official | temp | nickname | anonymous | old | maiden
Binding: NameUse (required): The use of a human name.

.... text Σ 0..1 string Text representation of the full name
.... family SΣ 1..1 string Family name (often called 'Surname')
.... given Σ 0..* string Given names (not always 'first'). Includes middle names
This repeating element order: Given Names appear in the correct order for presenting the name
.... prefix Σ 0..* string Parts that come before the name
This repeating element order: Prefixes appear in the correct order for presenting the name
.... suffix Σ 0..* string Parts that come after the name
This repeating element order: Suffixes appear in the correct order for presenting the name
.... period Σ 0..1 Period Time period when name was/is in use
... telecom SΣ 0..* ContactPoint A contact detail for the practitioner (that apply to all roles)
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... system SΣC 0..1 code phone | fax | email | pager | url | sms | other
Binding: ContactPointSystem (required): Telecommunications form for contact point.

.... value SΣ 0..1 string The actual contact point details
.... use ?!Σ 0..1 code home | work | temp | old | mobile - purpose of this contact point
Binding: ContactPointUse (required): Use of contact point.

.... rank Σ 0..1 positiveInt Specify preferred order of use (1 = highest)
.... period Σ 0..1 Period Time period when the contact point was/is in use
... address SΣ 0..* Address Address(es) of the practitioner
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... use ?!Σ 0..1 code home | work | temp | old | billing - purpose of this address
Binding: AddressUse (required): The use of an address.


Example General: home
.... type Σ 0..1 code postal | physical | both
Binding: AddressType (required): The type of an address (physical / postal).


Example General: both
.... text Σ 0..1 string Text representation of the address
Example General: 137 Nowhere Street, Erewhon 9132
.... line SΣ 0..4 string Street name, number, direction & P.O. Box etc.
This repeating element order: The order in which lines should appear in an address label
Example General: 137 Nowhere Street
.... city SΣ 0..1 string Name of city, town etc.
Example General: Erewhon
.... district Σ 0..1 string District name (aka county)
Example General: Madison
.... state SΣ 0..1 string Sub-unit of country (abbreviations ok)
Binding: USPS Two Letter Alphabetic Codes (extensible): Two letter USPS alphabetic codes.

.... postalCode SΣ 0..1 string US Zip Codes
Example General: 9132
.... country SΣ 0..1 string Country (e.g. can be ISO 3166 2 or 3 letter code)
.... period Σ 0..1 Period Time period when address was/is in use
Example General: {"start":"2010-03-23","end":"2010-07-01"}
... gender Σ 0..1 code male | female | other | unknown
Binding: AdministrativeGender (required): The gender of a person used for administrative purposes.

... birthDate Σ 0..1 date The date on which the practitioner was born
... photo 0..* Attachment Image of the person
... qualification 0..* BackboneElement Certification, licenses, or training pertaining to the provision of care
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... identifier 0..* Identifier An identifier for this qualification for the practitioner
.... code 1..1 CodeableConcept Coded representation of the qualification
Binding: v2 table 0360, Version 2.7 (example): Specific qualification the practitioner has to provide a service.

.... period 0..1 Period Period during which the qualification is valid
.... issuer 0..1 Reference(Organization) Organization that regulates and issues the qualification
... communication 0..* CodeableConcept A language the practitioner can use in patient communication
Binding: CommonLanguages (preferred): A human language.

Additional BindingsPurpose
AllLanguages Max Binding


doco Documentation for this format

Terminology Bindings

PathConformanceValueSetURI
Practitioner.meta.securityextensibleAll Security Labels
http://hl7.org/fhir/ValueSet/security-labels
from the FHIR Standard
Practitioner.meta.tagexampleCommonTags
http://hl7.org/fhir/ValueSet/common-tags
from the FHIR Standard
Practitioner.languagepreferredCommonLanguages
Additional Bindings Purpose
AllLanguages Max Binding
http://hl7.org/fhir/ValueSet/languages
from the FHIR Standard
Practitioner.name.userequiredNameUse
http://hl7.org/fhir/ValueSet/name-use|4.0.1
from the FHIR Standard
Practitioner.telecom.systemrequiredContactPointSystem
http://hl7.org/fhir/ValueSet/contact-point-system|4.0.1
from the FHIR Standard
Practitioner.telecom.userequiredContactPointUse
http://hl7.org/fhir/ValueSet/contact-point-use|4.0.1
from the FHIR Standard
Practitioner.address.userequiredAddressUse
http://hl7.org/fhir/ValueSet/address-use|4.0.1
from the FHIR Standard
Practitioner.address.typerequiredAddressType
http://hl7.org/fhir/ValueSet/address-type|4.0.1
from the FHIR Standard
Practitioner.address.stateextensibleUspsTwoLetterAlphabeticCodes (a valid code from https://www.usps.com/)
http://hl7.org/fhir/us/core/ValueSet/us-core-usps-state
Practitioner.genderrequiredAdministrativeGender
http://hl7.org/fhir/ValueSet/administrative-gender|4.0.1
from the FHIR Standard
Practitioner.qualification.codeexamplev2.0360.2.7 (a valid code from http://terminology.hl7.org/CodeSystem/v2-0360|2.7)
http://terminology.hl7.org/ValueSet/v2-2.7-0360
from the FHIR Standard
Practitioner.communicationpreferredCommonLanguages
Additional Bindings Purpose
AllLanguages Max Binding
http://hl7.org/fhir/ValueSet/languages
from the FHIR Standard

Constraints

IdGradePath(s)DetailsRequirements
Practitioner-identifiererrorPractitionerPractitioner.identifier must include an NPI or a Tax ID
: identifier.where(type.where(coding.where(code in ('NPI' | 'TAX')).exists()).exists()).exists()
practitioner-meta-profile-versionwarningPractitionerPractitioner: meta.profile with canonical and major.minor. version required.
: meta.profile.exists($this.startsWith('http://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-Practitioner|2.1'))

This structure is derived from USCorePractitionerProfile

Summary

Mandatory: 2 elements
Must-Support: 3 elements

Differential View

This structure is derived from USCorePractitionerProfile

NameFlagsCard.TypeDescription & Constraintsdoco
.. Practitioner C 0..* USCorePractitionerProfile(6.1.0) A person with a formal responsibility in the provisioning of healthcare or related services
This profile also complies with the profile US Core Practitioner Profile (3.1.1)
Practitioner-identifier: Practitioner.identifier must include an NPI or a Tax ID
practitioner-meta-profile-version: Practitioner: meta.profile with canonical and major.minor. version required.
... meta S 1..1 Meta Metadata about the resource
.... lastUpdated S 0..1 instant When the resource version last changed
.... profile 1..* canonical(StructureDefinition) Profiles this resource claims to conform to
... Slices for identifier Content/Rules for all slices
.... identifier:NPI 0..1 Identifier National Provider Identifier
Required Pattern: At least the following
..... type 1..1 CodeableConcept Description of identifier
Fixed Value: (complex)
...... coding 1..* Coding Code defined by a terminology system
Fixed Value: (complex)
....... system 1..1 uri Identity of the terminology system
Fixed Value: http://terminology.hl7.org/CodeSystem/v2-0203
....... code 1..1 code Symbol in syntax defined by the system
Fixed Value: NPI
..... system 1..1 uri The namespace for the identifier value
Fixed Value: http://hl7.org/fhir/sid/us-npi
.... identifier:tax S 0..* Identifier Tax ID Number

Required Pattern: At least the following
..... type 1..1 CodeableConcept Description of identifier
Fixed Value: (complex)
...... coding 1..* Coding Code defined by a terminology system
Fixed Value: (complex)
....... system 1..1 uri Identity of the terminology system
Fixed Value: http://terminology.hl7.org/CodeSystem/v2-0203
....... code 1..1 code Symbol in syntax defined by the system
Fixed Value: TAX
..... system 1..1 uri The namespace for the identifier value
Fixed Value: urn:oid:2.16.840.1.113883.4.4
... name 1..* HumanName The name(s) associated with the practitioner

doco Documentation for this format

Constraints

IdGradePath(s)DetailsRequirements
Practitioner-identifiererrorPractitionerPractitioner.identifier must include an NPI or a Tax ID
: identifier.where(type.where(coding.where(code in ('NPI' | 'TAX')).exists()).exists()).exists()
practitioner-meta-profile-versionwarningPractitionerPractitioner: meta.profile with canonical and major.minor. version required.
: meta.profile.exists($this.startsWith('http://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-Practitioner|2.1'))

Key Elements View

NameFlagsCard.TypeDescription & Constraintsdoco
.. Practitioner C 0..* USCorePractitionerProfile(6.1.0) A person with a formal responsibility in the provisioning of healthcare or related services
This profile also complies with the profile US Core Practitioner Profile (3.1.1)
Practitioner-identifier: Practitioner.identifier must include an NPI or a Tax ID
practitioner-meta-profile-version: Practitioner: meta.profile with canonical and major.minor. version required.
... meta SΣ 1..1 Meta Metadata about the resource
.... lastUpdated SΣ 0..1 instant When the resource version last changed
.... profile Σ 1..* canonical(StructureDefinition) Profiles this resource claims to conform to
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
.... identifier:NPI SΣC 0..1 Identifier National Provider Identifier
us-core-16: NPI must be 10 digits
us-core-17: NPI check digit must be valid (Luhn algorithm check)

Required Pattern: At least the following
..... type 1..1 CodeableConcept Description of identifier
Fixed Value: (complex)
...... coding 1..* Coding Code defined by a terminology system
Fixed Value: (complex)
....... system 1..1 uri Identity of the terminology system
Fixed Value: http://terminology.hl7.org/CodeSystem/v2-0203
....... code 1..1 code Symbol in syntax defined by the system
Fixed Value: NPI
..... system 1..1 uri The namespace for the identifier value
Fixed Value: http://hl7.org/fhir/sid/us-npi
.... identifier:tax SΣ 0..* Identifier Tax ID Number

Required Pattern: At least the following
..... type 1..1 CodeableConcept Description of identifier
Fixed Value: (complex)
...... coding 1..* Coding Code defined by a terminology system
Fixed Value: (complex)
....... system 1..1 uri Identity of the terminology system
Fixed Value: http://terminology.hl7.org/CodeSystem/v2-0203
....... code 1..1 code Symbol in syntax defined by the system
Fixed Value: TAX
..... system 1..1 uri The namespace for the identifier value
Fixed Value: urn:oid:2.16.840.1.113883.4.4
... name SΣ 1..* HumanName The name(s) associated with the practitioner
.... use ?!Σ 0..1 code usual | official | temp | nickname | anonymous | old | maiden
Binding: NameUse (required): The use of a human name.

.... family SΣ 1..1 string Family name (often called 'Surname')
... telecom SΣ 0..* ContactPoint A contact detail for the practitioner (that apply to all roles)
.... system SΣC 0..1 code phone | fax | email | pager | url | sms | other
Binding: ContactPointSystem (required): Telecommunications form for contact point.

.... value SΣ 0..1 string The actual contact point details
.... use ?!Σ 0..1 code home | work | temp | old | mobile - purpose of this contact point
Binding: ContactPointUse (required): Use of contact point.

... address SΣ 0..* Address Address(es) of the practitioner
.... use ?!Σ 0..1 code home | work | temp | old | billing - purpose of this address
Binding: AddressUse (required): The use of an address.


Example General: home
.... line SΣ 0..4 string Street name, number, direction & P.O. Box etc.
This repeating element order: The order in which lines should appear in an address label
Example General: 137 Nowhere Street
.... city SΣ 0..1 string Name of city, town etc.
Example General: Erewhon
.... state SΣ 0..1 string Sub-unit of country (abbreviations ok)
Binding: USPS Two Letter Alphabetic Codes (extensible): Two letter USPS alphabetic codes.

.... postalCode SΣ 0..1 string US Zip Codes
Example General: 9132
.... country SΣ 0..1 string Country (e.g. can be ISO 3166 2 or 3 letter code)

doco Documentation for this format

Terminology Bindings

PathConformanceValueSetURI
Practitioner.name.userequiredNameUse
http://hl7.org/fhir/ValueSet/name-use|4.0.1
from the FHIR Standard
Practitioner.telecom.systemrequiredContactPointSystem
http://hl7.org/fhir/ValueSet/contact-point-system|4.0.1
from the FHIR Standard
Practitioner.telecom.userequiredContactPointUse
http://hl7.org/fhir/ValueSet/contact-point-use|4.0.1
from the FHIR Standard
Practitioner.address.userequiredAddressUse
http://hl7.org/fhir/ValueSet/address-use|4.0.1
from the FHIR Standard
Practitioner.address.stateextensibleUspsTwoLetterAlphabeticCodes (a valid code from https://www.usps.com/)
http://hl7.org/fhir/us/core/ValueSet/us-core-usps-state

Constraints

IdGradePath(s)DetailsRequirements
Practitioner-identifiererrorPractitionerPractitioner.identifier must include an NPI or a Tax ID
: identifier.where(type.where(coding.where(code in ('NPI' | 'TAX')).exists()).exists()).exists()
practitioner-meta-profile-versionwarningPractitionerPractitioner: meta.profile with canonical and major.minor. version required.
: meta.profile.exists($this.startsWith('http://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-Practitioner|2.1'))

Snapshot View

NameFlagsCard.TypeDescription & Constraintsdoco
.. Practitioner C 0..* USCorePractitionerProfile(6.1.0) A person with a formal responsibility in the provisioning of healthcare or related services
This profile also complies with the profile US Core Practitioner Profile (3.1.1)
Practitioner-identifier: Practitioner.identifier must include an NPI or a Tax ID
practitioner-meta-profile-version: Practitioner: meta.profile with canonical and major.minor. version required.
... id Σ 0..1 id Logical id of this artifact
... meta SΣ 1..1 Meta Metadata about the resource
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... versionId Σ 0..1 id Version specific identifier
.... lastUpdated SΣ 0..1 instant When the resource version last changed
.... source Σ 0..1 uri Identifies where the resource comes from
.... profile Σ 1..* canonical(StructureDefinition) Profiles this resource claims to conform to
.... security Σ 0..* Coding Security Labels applied to this resource
Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.


.... tag Σ 0..* Coding Tags applied to this resource
Binding: CommonTags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".


... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... text 0..1 Narrative Text summary of the resource, for human interpretation
... contained 0..* Resource Contained, inline Resources
... extension 0..* Extension Additional content defined by implementations
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... Slices for identifier SΣ 1..* Identifier An identifier for the person as this agent
Slice: Unordered, Open by pattern:$this
.... identifier:NPI SΣC 0..1 Identifier National Provider Identifier
us-core-16: NPI must be 10 digits
us-core-17: NPI check digit must be valid (Luhn algorithm check)

Required Pattern: At least the following
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
..... use 0..1 code usual | official | temp | secondary | old (If known)
..... type 1..1 CodeableConcept Description of identifier
Fixed Value: (complex)
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
...... coding 1..* Coding Code defined by a terminology system
Fixed Value: (complex)
....... id 0..1 string Unique id for inter-element referencing
....... extension 0..* Extension Additional content defined by implementations
....... system 1..1 uri Identity of the terminology system
Fixed Value: http://terminology.hl7.org/CodeSystem/v2-0203
....... version 0..1 string Version of the system - if relevant
....... code 1..1 code Symbol in syntax defined by the system
Fixed Value: NPI
....... display 0..1 string Representation defined by the system
....... userSelected 0..1 boolean If this coding was chosen directly by the user
...... text 0..1 string Plain text representation of the concept
..... system 1..1 uri The namespace for the identifier value
Fixed Value: http://hl7.org/fhir/sid/us-npi
..... value 0..1 string The value that is unique
..... period 0..1 Period Time period when id is/was valid for use
..... assigner 0..1 Reference(Organization) Organization that issued id (may be just text)
.... identifier:tax SΣ 0..* Identifier Tax ID Number

Required Pattern: At least the following
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
..... use 0..1 code usual | official | temp | secondary | old (If known)
..... type 1..1 CodeableConcept Description of identifier
Fixed Value: (complex)
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
...... coding 1..* Coding Code defined by a terminology system
Fixed Value: (complex)
....... id 0..1 string Unique id for inter-element referencing
....... extension 0..* Extension Additional content defined by implementations
....... system 1..1 uri Identity of the terminology system
Fixed Value: http://terminology.hl7.org/CodeSystem/v2-0203
....... version 0..1 string Version of the system - if relevant
....... code 1..1 code Symbol in syntax defined by the system
Fixed Value: TAX
....... display 0..1 string Representation defined by the system
....... userSelected 0..1 boolean If this coding was chosen directly by the user
...... text 0..1 string Plain text representation of the concept
..... system 1..1 uri The namespace for the identifier value
Fixed Value: urn:oid:2.16.840.1.113883.4.4
..... value 0..1 string The value that is unique
..... period 0..1 Period Time period when id is/was valid for use
..... assigner 0..1 Reference(Organization) Organization that issued id (may be just text)
... active Σ 0..1 boolean Whether this practitioner's record is in active use
... name SΣ 1..* HumanName The name(s) associated with the practitioner
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... use ?!Σ 0..1 code usual | official | temp | nickname | anonymous | old | maiden
Binding: NameUse (required): The use of a human name.

.... text Σ 0..1 string Text representation of the full name
.... family SΣ 1..1 string Family name (often called 'Surname')
.... given Σ 0..* string Given names (not always 'first'). Includes middle names
This repeating element order: Given Names appear in the correct order for presenting the name
.... prefix Σ 0..* string Parts that come before the name
This repeating element order: Prefixes appear in the correct order for presenting the name
.... suffix Σ 0..* string Parts that come after the name
This repeating element order: Suffixes appear in the correct order for presenting the name
.... period Σ 0..1 Period Time period when name was/is in use
... telecom SΣ 0..* ContactPoint A contact detail for the practitioner (that apply to all roles)
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... system SΣC 0..1 code phone | fax | email | pager | url | sms | other
Binding: ContactPointSystem (required): Telecommunications form for contact point.

.... value SΣ 0..1 string The actual contact point details
.... use ?!Σ 0..1 code home | work | temp | old | mobile - purpose of this contact point
Binding: ContactPointUse (required): Use of contact point.

.... rank Σ 0..1 positiveInt Specify preferred order of use (1 = highest)
.... period Σ 0..1 Period Time period when the contact point was/is in use
... address SΣ 0..* Address Address(es) of the practitioner
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... use ?!Σ 0..1 code home | work | temp | old | billing - purpose of this address
Binding: AddressUse (required): The use of an address.


Example General: home
.... type Σ 0..1 code postal | physical | both
Binding: AddressType (required): The type of an address (physical / postal).


Example General: both
.... text Σ 0..1 string Text representation of the address
Example General: 137 Nowhere Street, Erewhon 9132
.... line SΣ 0..4 string Street name, number, direction & P.O. Box etc.
This repeating element order: The order in which lines should appear in an address label
Example General: 137 Nowhere Street
.... city SΣ 0..1 string Name of city, town etc.
Example General: Erewhon
.... district Σ 0..1 string District name (aka county)
Example General: Madison
.... state SΣ 0..1 string Sub-unit of country (abbreviations ok)
Binding: USPS Two Letter Alphabetic Codes (extensible): Two letter USPS alphabetic codes.

.... postalCode SΣ 0..1 string US Zip Codes
Example General: 9132
.... country SΣ 0..1 string Country (e.g. can be ISO 3166 2 or 3 letter code)
.... period Σ 0..1 Period Time period when address was/is in use
Example General: {"start":"2010-03-23","end":"2010-07-01"}
... gender Σ 0..1 code male | female | other | unknown
Binding: AdministrativeGender (required): The gender of a person used for administrative purposes.

... birthDate Σ 0..1 date The date on which the practitioner was born
... photo 0..* Attachment Image of the person
... qualification 0..* BackboneElement Certification, licenses, or training pertaining to the provision of care
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... identifier 0..* Identifier An identifier for this qualification for the practitioner
.... code 1..1 CodeableConcept Coded representation of the qualification
Binding: v2 table 0360, Version 2.7 (example): Specific qualification the practitioner has to provide a service.

.... period 0..1 Period Period during which the qualification is valid
.... issuer 0..1 Reference(Organization) Organization that regulates and issues the qualification
... communication 0..* CodeableConcept A language the practitioner can use in patient communication
Binding: CommonLanguages (preferred): A human language.

Additional BindingsPurpose
AllLanguages Max Binding


doco Documentation for this format

Terminology Bindings

PathConformanceValueSetURI
Practitioner.meta.securityextensibleAll Security Labels
http://hl7.org/fhir/ValueSet/security-labels
from the FHIR Standard
Practitioner.meta.tagexampleCommonTags
http://hl7.org/fhir/ValueSet/common-tags
from the FHIR Standard
Practitioner.languagepreferredCommonLanguages
Additional Bindings Purpose
AllLanguages Max Binding
http://hl7.org/fhir/ValueSet/languages
from the FHIR Standard
Practitioner.name.userequiredNameUse
http://hl7.org/fhir/ValueSet/name-use|4.0.1
from the FHIR Standard
Practitioner.telecom.systemrequiredContactPointSystem
http://hl7.org/fhir/ValueSet/contact-point-system|4.0.1
from the FHIR Standard
Practitioner.telecom.userequiredContactPointUse
http://hl7.org/fhir/ValueSet/contact-point-use|4.0.1
from the FHIR Standard
Practitioner.address.userequiredAddressUse
http://hl7.org/fhir/ValueSet/address-use|4.0.1
from the FHIR Standard
Practitioner.address.typerequiredAddressType
http://hl7.org/fhir/ValueSet/address-type|4.0.1
from the FHIR Standard
Practitioner.address.stateextensibleUspsTwoLetterAlphabeticCodes (a valid code from https://www.usps.com/)
http://hl7.org/fhir/us/core/ValueSet/us-core-usps-state
Practitioner.genderrequiredAdministrativeGender
http://hl7.org/fhir/ValueSet/administrative-gender|4.0.1
from the FHIR Standard
Practitioner.qualification.codeexamplev2.0360.2.7 (a valid code from http://terminology.hl7.org/CodeSystem/v2-0360|2.7)
http://terminology.hl7.org/ValueSet/v2-2.7-0360
from the FHIR Standard
Practitioner.communicationpreferredCommonLanguages
Additional Bindings Purpose
AllLanguages Max Binding
http://hl7.org/fhir/ValueSet/languages
from the FHIR Standard

Constraints

IdGradePath(s)DetailsRequirements
Practitioner-identifiererrorPractitionerPractitioner.identifier must include an NPI or a Tax ID
: identifier.where(type.where(coding.where(code in ('NPI' | 'TAX')).exists()).exists()).exists()
practitioner-meta-profile-versionwarningPractitionerPractitioner: meta.profile with canonical and major.minor. version required.
: meta.profile.exists($this.startsWith('http://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-Practitioner|2.1'))

This structure is derived from USCorePractitionerProfile

Summary

Mandatory: 2 elements
Must-Support: 3 elements

 

Other representations of profile: CSV, Excel, Schematron