National Directory of Healthcare Providers & Services (NDH) Implementation Guide
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National Directory of Healthcare Providers & Services (NDH) Implementation Guide, published by HL7 International / Patient Administration. This guide is not an authorized publication; it is the continuous build for version 1.0.0-ballot built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/fhir-us-ndh/ and changes regularly. See the Directory of published versions

Resource Profile: NdhPractitionerRole - Detailed Descriptions

Active as of 2024-06-17

Definitions for the ndh-PractitionerRole resource profile.

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

0. PractitionerRole
Invariantspractitioner-or-organization-or-healthcareservice-or-location: If NdhPractitionerRole.practitioner is absent ( NdhPractitionerRole.organization, NdhPractitionerRole.healthcareservice, NdhPractitionerRole.location) must be present (practitioner.exists() or (organization.exists() or healthcareService.exists() or location.exists()))
2. PractitionerRole.meta
4. PractitionerRole.meta.lastUpdated
Control1..?
6. PractitionerRole.extension
SlicingThis element introduces a set of slices on PractitionerRole.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
  • value @ url
  • 8. PractitionerRole.extension:rating
    Slice Namerating
    Control0..*
    TypeExtension(NDH Rating) (Complex Extension)
    10. PractitionerRole.extension:newpatients
    Slice Namenewpatients
    ShortNew Patients
    Control0..*
    TypeExtension(NDH New Patients) (Complex Extension)
    12. PractitionerRole.extension:network
    Slice Namenetwork
    ShortNetworkReference
    Control0..1
    TypeExtension(NDH Network Reference) (Extension Type: Reference(NDH Base Network Profile))
    14. PractitionerRole.extension:usage-restriction
    Slice Nameusage-restriction
    ShortUsage Restriction
    Control0..*
    TypeExtension(NDH Usage Restriction) (Extension Type: Reference(NDH Base Restriction)contained)
    16. PractitionerRole.extension:digitalcertificate
    Slice Namedigitalcertificate
    ShortDigital Certificate
    Control0..*
    TypeExtension(NDH Digitalcertificate) (Complex Extension)
    18. PractitionerRole.extension:qualification
    Slice Namequalification
    ShortQualification
    Control0..*
    TypeExtension(NDH Qualification) (Complex Extension)
    20. PractitionerRole.extension:verification-status
    Slice Nameverification-status
    Control0..1
    TypeExtension(NDH Verification Status) (Extension Type: CodeableConcept)
    22. PractitionerRole.identifier
    NoteThis is a business identifier, not a resource identifier (see discussion)
    Must Supporttrue
    24. PractitionerRole.identifier.extension:identifier-status
    Slice Nameidentifier-status
    Control0..1
    TypeExtension(NDH Identifier Status) (Extension Type: code)
    26. PractitionerRole.identifier.assigner
    TypeReference(NDH Base Organization Profile)
    28. PractitionerRole.active
    Control1..?
    Pattern Valuetrue
    30. PractitionerRole.practitioner
    TypeReference(NDH Base Practitioner Profile)
    32. PractitionerRole.organization
    Definition

    The organization where this role is available

    ShortOrganization where the role is available
    Comments

    Some relationships (represented as PractitionerRoles) that may exist between practitioners and organizations include:

    • A practitioner may act as a pediatrician when associated with an organization that runs a family clinic. PractitionerRole.organization would represent the family clinic.
    • The same practitioner may act as a physician when providing physicals for an athletics department at a school. PractitionerRole.organization would represent the school.
    • A practitioner may perform coumadin anticoagulation services for a clinic run by a health system. PractitionerRole.organization would represent the coumadin clinic.
    • A practitioner may act as an inpatient pharmacist reviewing and dispensing medications. PractitionerRole.organization would represent the hospital pharmacy.
    • A practitioner may perform medication management and adherence services for an internal medicine clinic. PractitionerRole.organization would represent the internal medicine clinic.
    • A practitioner is part of a payer's network such as a preferred provider organization (PPO), or health maintenance organizations (HMO)).
      PractitionerRole.organization would represent the payer's network. Each of the examples above, would be represented as different PractitionerRole instances, each with a different values for PractitionerRole.organization.
    TypeReference(NDH Base Organization Profile)
    34. PractitionerRole.code
    SlicingThis element introduces a set of slices on PractitionerRole.code. The slices areUnordered and Open, and can be differentiated using the following discriminators:
    • pattern @ $this
    • 36. PractitionerRole.code:NDHPractitionerRoleCode
      Slice NameNDHPractitionerRoleCode
      ShortNDH PractitionerRole Code
      Control0..*
      BindingThe codes SHALL be taken from PractitionerRole Code Value Set
      (required to http://hl7.org/fhir/us/ndh/ValueSet/PractitionerRoleVS)
      38. PractitionerRole.specialty
      BindingUnless not suitable, these codes SHALL be taken from Individual and Group Specialties
      (extensible to http://hl7.org/fhir/us/ndh/ValueSet/IndividualAndGroupSpecialtiesVS)
      40. PractitionerRole.location
      TypeReference(NDH Base Location Profile)
      42. PractitionerRole.healthcareService
      TypeReference(NDH Base HealthcareService Profile)
      Must Supporttrue
      44. PractitionerRole.telecom
      46. PractitionerRole.telecom.extension:contactpoint-availabletime
      Slice Namecontactpoint-availabletime
      Control0..*
      TypeExtension(NDH Contactpoint Availabletime) (Complex Extension)
      48. PractitionerRole.telecom.extension:via-intermediary
      Slice Namevia-intermediary
      ShortVia Intermediary
      Control0..1
      TypeExtension(NDH Via Intermediary) (Extension Type: Reference(NDH Base PractitionerRole, NDH Base OrganizationAffiliation Profile, NDH Base Location Profile, NDH Base Organization Profile))
      50. PractitionerRole.endpoint
      TypeReference(NDH Base Endpoint Profile)

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

      0. PractitionerRole
      Definition

      -


      A specific set of Roles/Locations/specialties/services that a practitioner may perform at an organization for a period of time.

      ShortRoles/organizations the practitioner is associated with
      Comments

      -

      Control0..*
      Is Modifierfalse
      Must Supportfalse
      Summaryfalse
      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())
      pd-1: SHALL have contact information or a reference to an Endpoint (telecom or endpoint)
      us-core-13: SHALL have a practitioner, an organization, a healthcare service, or a location. (practitioner or organization or healthcareService or location)
      practitioner-or-organization-or-healthcareservice-or-location: If NdhPractitionerRole.practitioner is absent ( NdhPractitionerRole.organization, NdhPractitionerRole.healthcareservice, NdhPractitionerRole.location) must be present (practitioner.exists() or (organization.exists() or healthcareService.exists() or location.exists()))
      2. PractitionerRole.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. PractitionerRole.extension
      Definition

      An Extension


      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.

      ShortExtensionAdditional 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 PractitionerRole.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
      • value @ url
      • 6. PractitionerRole.extension:rating
        Slice Namerating
        Definition

        Rating

        ShortNDH Rating
        Control0..*
        This element is affected by the following invariants: ele-1
        TypeExtension(NDH Rating) (Complex Extension)
        Is Modifierfalse
        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())
        8. PractitionerRole.extension:newpatients
        Slice Namenewpatients
        Definition

        New Patients indicates whether new patients are being accepted in general, or from a specific network.
        This extension is included in the PractitionerRole, HealthcareService, and Location profiles.
        This provides needed flexibility for specifying whether a provider accepts new patients by location and network.

        ShortNew Patients
        Control0..*
        This element is affected by the following invariants: ele-1
        TypeExtension(NDH New Patients) (Complex Extension)
        Is Modifierfalse
        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())
        new-patients-characteristics: If no new patients are accepted, no characteristics are allowed (extension('http://hl7.org/fhir/us/ndh/StructureDefinition/base-ext-newpatients').value.coding.exists(code = 'nopt') implies extension('http://hl7.org/fhir/us/ndh/StructureDefinition/base-ext-newpatients-characteristics').empty())
        10. PractitionerRole.extension:network
        Slice Namenetwork
        Definition

        A reference to the healthcare provider insurance networks (NdhNetwork) the practitioner participates in through their role

        ShortNetworkReference
        Control0..1
        This element is affected by the following invariants: ele-1
        TypeExtension(NDH Network Reference) (Extension Type: Reference(NDH Base Network Profile))
        Is Modifierfalse
        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())
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        12. PractitionerRole.extension:usage-restriction
        Slice Nameusage-restriction
        Definition

        Identifies and conveys information about restrictions on the use or release of exchanged information, e.g. information that can only be shared under particular condition, such as a signed data use agreement between parties

        ShortUsage Restriction
        Control0..*
        This element is affected by the following invariants: ele-1
        TypeExtension(NDH Usage Restriction) (Extension Type: Reference(NDH Base Restriction)contained)
        Is Modifierfalse
        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())
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        14. PractitionerRole.extension:digitalcertificate
        Slice Namedigitalcertificate
        Definition

        A digital certificate, used to identify a user or group of users, or for encrypted communications

        ShortDigital Certificate
        Control0..*
        This element is affected by the following invariants: ele-1
        TypeExtension(NDH Digitalcertificate) (Complex Extension)
        Is Modifierfalse
        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. PractitionerRole.extension:qualification
        Slice Namequalification
        Definition

        An extension to add qualifications for an organization (e.g. accreditation) or practitionerRole (e.g. registered to prescribe controlled substances).

        ShortQualification
        Control0..*
        This element is affected by the following invariants: ele-1
        TypeExtension(NDH Qualification) (Complex Extension)
        Is Modifierfalse
        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. PractitionerRole.extension:verification-status
        Slice Nameverification-status
        Definition

        Indicates a resource instance verification status

        ShortNDH Verification Status
        Control0..1
        This element is affected by the following invariants: ele-1
        TypeExtension(NDH Verification Status) (Extension Type: CodeableConcept)
        Is Modifierfalse
        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())
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        20. PractitionerRole.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())
        22. PractitionerRole.identifier
        Definition

        Business Identifiers that are specific to a role/location.

        ShortBusiness Identifiers that are specific to a role/location
        NoteThis is a business identifier, not a resource identifier (see discussion)
        Control0..*
        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()))
        24. PractitionerRole.identifier.extension:identifier-status
        Slice Nameidentifier-status
        Definition

        Describes the status of an identifier

        ShortNDH Identifier Status
        Control0..1
        TypeExtension(NDH Identifier Status) (Extension Type: code)
        Is Modifierfalse
        Summaryfalse
        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())
        26. PractitionerRole.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()))
        28. PractitionerRole.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(NDH Base Organization Profile, Organization)
        Is Modifierfalse
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        30. PractitionerRole.active
        Definition

        Whether this practitioner role record is in active use.

        ShortWhether this practitioner role record is in active use
        Comments

        If this value is false, you may refer to the period to see when the role was in active use. If there is no period specified, no inference can be made about when it was active.

        Control10..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 role record as not to be used because it was created in error, or otherwise no longer in active use.

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

        Practitioner that is able to provide the defined services for the organization.

        ShortPractitioner that is able to provide the defined services for the organization
        Control0..1
        This element is affected by the following invariants: us-core-13
        TypeReference(NDH Base Practitioner Profile, Practitioner)
        Is Modifierfalse
        Must Supporttrue
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        34. PractitionerRole.organization
        Definition

        The organization where this role is available


        The organization where the Practitioner performs the roles associated.

        ShortOrganization where the role is availableOrganization where the roles are available
        Comments

        Some relationships (represented as PractitionerRoles) that may exist between practitioners and organizations include:

        • A practitioner may act as a pediatrician when associated with an organization that runs a family clinic. PractitionerRole.organization would represent the family clinic.
        • The same practitioner may act as a physician when providing physicals for an athletics department at a school. PractitionerRole.organization would represent the school.
        • A practitioner may perform coumadin anticoagulation services for a clinic run by a health system. PractitionerRole.organization would represent the coumadin clinic.
        • A practitioner may act as an inpatient pharmacist reviewing and dispensing medications. PractitionerRole.organization would represent the hospital pharmacy.
        • A practitioner may perform medication management and adherence services for an internal medicine clinic. PractitionerRole.organization would represent the internal medicine clinic.
        • A practitioner is part of a payer's network such as a preferred provider organization (PPO), or health maintenance organizations (HMO)).
          PractitionerRole.organization would represent the payer's network. Each of the examples above, would be represented as different PractitionerRole instances, each with a different values for PractitionerRole.organization.
        Control0..1
        This element is affected by the following invariants: us-core-13
        TypeReference(NDH Base Organization Profile, Organization)
        Is Modifierfalse
        Must Supporttrue
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        36. PractitionerRole.code
        Definition

        Roles which this practitioner is authorized to perform for the organization.

        ShortRoles which this practitioner may perform
        Comments

        A person may have more than one role.

        Control0..*
        BindingUnless not suitable, these codes SHALL be taken from For example codes, see Care Team Member Function .http://hl7.org/fhir/ValueSet/practitioner-role
        (extensible to http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1099.30)

        Indicates specific responsibility of an individual within the care team, such as Primary physician, Team coordinator, Caregiver, etc.


        The role a person plays representing an organization.

        TypeCodeableConcept
        Is Modifierfalse
        Must Supporttrue
        Summarytrue
        Requirements

        Need to know what authority the practitioner has - what can they do?

        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 PractitionerRole.code. The slices areUnordered and Open, and can be differentiated using the following discriminators:
        • pattern @ $this
        • 38. PractitionerRole.code:NDHPractitionerRoleCode
          Slice NameNDHPractitionerRoleCode
          Definition

          Roles which this practitioner is authorized to perform for the organization.

          ShortNDH PractitionerRole CodeRoles which this practitioner may perform
          Comments

          A person may have more than one role.

          Control0..*
          BindingThe codes SHALL be taken from For example codes, see PractitionerRole Code Value Sethttp://hl7.org/fhir/ValueSet/practitioner-role
          (required to http://hl7.org/fhir/us/ndh/ValueSet/PractitionerRoleVS)
          TypeCodeableConcept
          Is Modifierfalse
          Must Supporttrue
          Summarytrue
          Requirements

          Need to know what authority the practitioner has - what can they do?

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

          Specific specialty of the practitioner.

          ShortSpecific specialty of the practitioner
          Control0..*
          BindingUnless not suitable, these codes SHALL be taken from The codes SHOULD be taken from Individual and Group Specialtieshttp://hl7.org/fhir/ValueSet/c80-practice-codes
          (extensible to http://hl7.org/fhir/us/ndh/ValueSet/IndividualAndGroupSpecialtiesVS)
          TypeCodeableConcept
          Is Modifierfalse
          Must Supporttrue
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          42. PractitionerRole.location
          Definition

          The location(s) at which this practitioner provides care.

          ShortThe location(s) at which this practitioner provides care
          Control0..*
          This element is affected by the following invariants: us-core-13
          TypeReference(NDH Base Location Profile, Location)
          Is Modifierfalse
          Must Supporttrue
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          44. PractitionerRole.healthcareService
          Definition

          The list of healthcare services that this worker provides for this role's Organization/Location(s).

          ShortThe list of healthcare services that this worker provides for this role's Organization/Location(s)
          Control0..*
          This element is affected by the following invariants: us-core-13
          TypeReference(NDH Base HealthcareService Profile, HealthcareService)
          Is Modifierfalse
          Must Supporttrue
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          46. PractitionerRole.telecom
          Definition

          Contact details that are specific to the role/location/service.

          ShortContact details that are specific to the role/location/service
          Control0..*
          This element is affected by the following invariants: pd-1
          TypeContactPoint
          Is Modifierfalse
          Must Supporttrue
          Summarytrue
          Requirements

          Often practitioners have a dedicated line for each location (or service) that they work at, and need to be able to define separate contact details for each of these.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          48. PractitionerRole.telecom.extension:contactpoint-availabletime
          Slice Namecontactpoint-availabletime
          Definition

          An extension representing the days and times a contact point is available

          ShortNDH Contactpoint Availabletime
          Control0..*
          TypeExtension(NDH Contactpoint Availabletime) (Complex Extension)
          Is Modifierfalse
          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())
          50. PractitionerRole.telecom.extension:via-intermediary
          Slice Namevia-intermediary
          Definition

          A reference to an alternative point of contact (NdhPractitionerRole, NdhOrganization, NdhOrganizationAffiliation, or NdhLocation) for this organization

          ShortVia Intermediary
          Control0..1
          TypeExtension(NDH Via Intermediary) (Extension Type: Reference(NDH Base PractitionerRole, NDH Base OrganizationAffiliation Profile, NDH Base Location Profile, NDH Base Organization Profile))
          Is Modifierfalse
          Summaryfalse
          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())
          52. PractitionerRole.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
          Control10..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()))
          54. PractitionerRole.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.

          Control10..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()))
          56. PractitionerRole.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()))
          58. PractitionerRole.endpoint
          Definition

          Technical endpoints providing access to services operated for the practitioner with this role.

          ShortTechnical endpoints providing access to services operated for the practitioner with this role
          Control0..*
          This element is affected by the following invariants: pd-1
          TypeReference(NDH Base Endpoint Profile, Endpoint)
          Is Modifierfalse
          Must Supporttrue
          Summaryfalse
          Requirements

          Organizations have multiple systems that provide various services and ,ay also be different for practitioners too.

          So the endpoint satisfies the need to be able to define the technical connection details for how to connect to them, and for what purpose.

          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. PractitionerRole
          Definition

          -

          ShortRoles/organizations the practitioner is associated with
          Comments

          -

          Control0..*
          Is Modifierfalse
          Must Supportfalse
          Summaryfalse
          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())
          pd-1: SHALL have contact information or a reference to an Endpoint (telecom or endpoint)
          us-core-13: SHALL have a practitioner, an organization, a healthcare service, or a location. (practitioner or organization or healthcareService or location)
          practitioner-or-organization-or-healthcareservice-or-location: If NdhPractitionerRole.practitioner is absent ( NdhPractitionerRole.organization, NdhPractitionerRole.healthcareservice, NdhPractitionerRole.location) must be present (practitioner.exists() or (organization.exists() or healthcareService.exists() or location.exists()))
          2. PractitionerRole.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. PractitionerRole.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. PractitionerRole.meta.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
          8. PractitionerRole.meta.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 PractitionerRole.meta.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
          • value @ url
          • 10. PractitionerRole.meta.versionId
            Definition

            The version specific identifier, as it appears in the version portion of the URL. This value changes when the resource is created, updated, or deleted.

            ShortVersion specific identifier
            Comments

            The server assigns this value, and ignores what the client specifies, except in the case that the server is imposing version integrity on updates/deletes.

            Control0..1
            Typeid
            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()))
            12. PractitionerRole.meta.lastUpdated
            Definition

            When the resource last changed - e.g. when the version changed.

            ShortWhen the resource version last changed
            Comments

            This value is always populated except when the resource is first being created. The server / resource manager sets this value; what a client provides is irrelevant. This is equivalent to the HTTP Last-Modified and SHOULD have the same value on a read interaction.

            Control1..1
            Typeinstant
            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()))
            14. PractitionerRole.meta.source
            Definition

            A uri that identifies the source system of the resource. This provides a minimal amount of Provenance information that can be used to track or differentiate the source of information in the resource. The source may identify another FHIR server, document, message, database, etc.

            ShortIdentifies where the resource comes from
            Comments

            In the provenance resource, this corresponds to Provenance.entity.what[x]. The exact use of the source (and the implied Provenance.entity.role) is left to implementer discretion. Only one nominated source is allowed; for additional provenance details, a full Provenance resource should be used.

            This element can be used to indicate where the current master source of a resource that has a canonical URL if the resource is no longer hosted at the canonical URL.

            Control0..1
            Typeuri
            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()))
            16. PractitionerRole.meta.profile
            Definition

            A list of profiles (references to StructureDefinition resources) that this resource claims to conform to. The URL is a reference to StructureDefinition.url.

            ShortProfiles this resource claims to conform to
            Comments

            It is up to the server and/or other infrastructure of policy to determine whether/how these claims are verified and/or updated over time. The list of profile URLs is a set.

            Control0..*
            Typecanonical(StructureDefinition)
            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()))
            18. PractitionerRole.meta.security
            Definition

            Security labels applied to this resource. These tags connect specific resources to the overall security policy and infrastructure.

            ShortSecurity Labels applied to this resource
            Comments

            The security labels can be updated without changing the stated version of the resource. The list of security labels is a set. Uniqueness is based the system/code, and version and display are ignored.

            Control0..*
            BindingUnless not suitable, these codes SHALL be taken from All Security Labels
            (extensible to http://hl7.org/fhir/ValueSet/security-labels)

            Security Labels from the Healthcare Privacy and Security Classification System.

            TypeCoding
            Is Modifierfalse
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            20. PractitionerRole.meta.tag
            Definition

            Tags applied to this resource. Tags are intended to be used to identify and relate resources to process and workflow, and applications are not required to consider the tags when interpreting the meaning of a resource.

            ShortTags applied to this resource
            Comments

            The tags can be updated without changing the stated version of the resource. The list of tags is a set. Uniqueness is based the system/code, and version and display are ignored.

            Control0..*
            BindingFor example codes, see CommonTags
            (example to http://hl7.org/fhir/ValueSet/common-tags)

            Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".

            TypeCoding
            Is Modifierfalse
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            22. PractitionerRole.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()))
            24. PractitionerRole.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()))
            26. PractitionerRole.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()))
            28. PractitionerRole.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
            30. PractitionerRole.extension
            Definition

            An Extension

            ShortExtension
            Control0..*
            TypeExtension
            Is Modifierfalse
            Summaryfalse
            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 PractitionerRole.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
            • value @ url
            • 32. PractitionerRole.extension:rating
              Slice Namerating
              Definition

              Rating

              ShortNDH Rating
              Control0..*
              This element is affected by the following invariants: ele-1
              TypeExtension(NDH Rating) (Complex Extension)
              Is Modifierfalse
              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())
              34. PractitionerRole.extension:newpatients
              Slice Namenewpatients
              Definition

              New Patients indicates whether new patients are being accepted in general, or from a specific network.
              This extension is included in the PractitionerRole, HealthcareService, and Location profiles.
              This provides needed flexibility for specifying whether a provider accepts new patients by location and network.

              ShortNew Patients
              Control0..*
              This element is affected by the following invariants: ele-1
              TypeExtension(NDH New Patients) (Complex Extension)
              Is Modifierfalse
              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())
              new-patients-characteristics: If no new patients are accepted, no characteristics are allowed (extension('http://hl7.org/fhir/us/ndh/StructureDefinition/base-ext-newpatients').value.coding.exists(code = 'nopt') implies extension('http://hl7.org/fhir/us/ndh/StructureDefinition/base-ext-newpatients-characteristics').empty())
              36. PractitionerRole.extension:network
              Slice Namenetwork
              Definition

              A reference to the healthcare provider insurance networks (NdhNetwork) the practitioner participates in through their role

              ShortNetworkReference
              Control0..1
              This element is affected by the following invariants: ele-1
              TypeExtension(NDH Network Reference) (Extension Type: Reference(NDH Base Network Profile))
              Is Modifierfalse
              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())
              38. PractitionerRole.extension:usage-restriction
              Slice Nameusage-restriction
              Definition

              Identifies and conveys information about restrictions on the use or release of exchanged information, e.g. information that can only be shared under particular condition, such as a signed data use agreement between parties

              ShortUsage Restriction
              Control0..*
              This element is affected by the following invariants: ele-1
              TypeExtension(NDH Usage Restriction) (Extension Type: Reference(NDH Base Restriction)contained)
              Is Modifierfalse
              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())
              40. PractitionerRole.extension:digitalcertificate
              Slice Namedigitalcertificate
              Definition

              A digital certificate, used to identify a user or group of users, or for encrypted communications

              ShortDigital Certificate
              Control0..*
              This element is affected by the following invariants: ele-1
              TypeExtension(NDH Digitalcertificate) (Complex Extension)
              Is Modifierfalse
              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())
              42. PractitionerRole.extension:qualification
              Slice Namequalification
              Definition

              An extension to add qualifications for an organization (e.g. accreditation) or practitionerRole (e.g. registered to prescribe controlled substances).

              ShortQualification
              Control0..*
              This element is affected by the following invariants: ele-1
              TypeExtension(NDH Qualification) (Complex Extension)
              Is Modifierfalse
              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())
              44. PractitionerRole.extension:verification-status
              Slice Nameverification-status
              Definition

              Indicates a resource instance verification status

              ShortNDH Verification Status
              Control0..1
              This element is affected by the following invariants: ele-1
              TypeExtension(NDH Verification Status) (Extension Type: CodeableConcept)
              Is Modifierfalse
              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())
              46. PractitionerRole.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())
              48. PractitionerRole.identifier
              Definition

              Business Identifiers that are specific to a role/location.

              ShortBusiness Identifiers that are specific to a role/location
              NoteThis is a business identifier, not a resource identifier (see discussion)
              Control0..*
              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()))
              50. PractitionerRole.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
              52. PractitionerRole.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 PractitionerRole.identifier.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
              • value @ url
              • 54. PractitionerRole.identifier.extension:identifier-status
                Slice Nameidentifier-status
                Definition

                Describes the status of an identifier

                ShortNDH Identifier Status
                Control0..1
                TypeExtension(NDH Identifier Status) (Extension Type: code)
                Is Modifierfalse
                Summaryfalse
                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())
                56. PractitionerRole.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()))
                58. PractitionerRole.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()))
                60. PractitionerRole.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.

                Control0..1
                Typeuri
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                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()))
                62. PractitionerRole.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.

                Control0..1
                Typestring
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Summarytrue
                Example<br/><b>General</b>:123456
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                64. PractitionerRole.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()))
                66. PractitionerRole.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(NDH Base Organization Profile)
                Is Modifierfalse
                Summarytrue
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                68. PractitionerRole.active
                Definition

                Whether this practitioner role record is in active use.

                ShortWhether this practitioner role record is in active use
                Comments

                If this value is false, you may refer to the period to see when the role was in active use. If there is no period specified, no inference can be made about when it was active.

                Control1..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 role record as not to be used because it was created in error, or otherwise no longer in active use.

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

                The period during which the person is authorized to act as a practitioner in these role(s) for the organization.

                ShortThe period during which the practitioner is authorized to perform in these role(s)
                Control0..1
                TypePeriod
                Is Modifierfalse
                Summarytrue
                Requirements

                Even after the agencies is revoked, the fact that it existed must still be recorded.

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

                Practitioner that is able to provide the defined services for the organization.

                ShortPractitioner that is able to provide the defined services for the organization
                Control0..1
                This element is affected by the following invariants: us-core-13
                TypeReference(NDH Base Practitioner Profile)
                Is Modifierfalse
                Must Supporttrue
                Summarytrue
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                74. PractitionerRole.organization
                Definition

                The organization where this role is available

                ShortOrganization where the role is available
                Comments

                Some relationships (represented as PractitionerRoles) that may exist between practitioners and organizations include:

                • A practitioner may act as a pediatrician when associated with an organization that runs a family clinic. PractitionerRole.organization would represent the family clinic.
                • The same practitioner may act as a physician when providing physicals for an athletics department at a school. PractitionerRole.organization would represent the school.
                • A practitioner may perform coumadin anticoagulation services for a clinic run by a health system. PractitionerRole.organization would represent the coumadin clinic.
                • A practitioner may act as an inpatient pharmacist reviewing and dispensing medications. PractitionerRole.organization would represent the hospital pharmacy.
                • A practitioner may perform medication management and adherence services for an internal medicine clinic. PractitionerRole.organization would represent the internal medicine clinic.
                • A practitioner is part of a payer's network such as a preferred provider organization (PPO), or health maintenance organizations (HMO)).
                  PractitionerRole.organization would represent the payer's network. Each of the examples above, would be represented as different PractitionerRole instances, each with a different values for PractitionerRole.organization.
                Control0..1
                This element is affected by the following invariants: us-core-13
                TypeReference(NDH Base Organization Profile)
                Is Modifierfalse
                Must Supporttrue
                Summarytrue
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                76. PractitionerRole.code
                Definition

                Roles which this practitioner is authorized to perform for the organization.

                ShortRoles which this practitioner may perform
                Comments

                A person may have more than one role.

                Control0..*
                BindingUnless not suitable, these codes SHALL be taken from Care Team Member Function .
                (extensible to http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1099.30)

                Indicates specific responsibility of an individual within the care team, such as Primary physician, Team coordinator, Caregiver, etc.

                TypeCodeableConcept
                Is Modifierfalse
                Must Supporttrue
                Summarytrue
                Requirements

                Need to know what authority the practitioner has - what can they do?

                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 PractitionerRole.code. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                • pattern @ $this
                • 78. PractitionerRole.code:NDHPractitionerRoleCode
                  Slice NameNDHPractitionerRoleCode
                  Definition

                  Roles which this practitioner is authorized to perform for the organization.

                  ShortNDH PractitionerRole Code
                  Comments

                  A person may have more than one role.

                  Control0..*
                  BindingThe codes SHALL be taken from PractitionerRole Code Value Set
                  (required to http://hl7.org/fhir/us/ndh/ValueSet/PractitionerRoleVS)
                  TypeCodeableConcept
                  Is Modifierfalse
                  Must Supporttrue
                  Summarytrue
                  Requirements

                  Need to know what authority the practitioner has - what can they do?

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

                  Specific specialty of the practitioner.

                  ShortSpecific specialty of the practitioner
                  Control0..*
                  BindingUnless not suitable, these codes SHALL be taken from Individual and Group Specialties
                  (extensible to http://hl7.org/fhir/us/ndh/ValueSet/IndividualAndGroupSpecialtiesVS)
                  TypeCodeableConcept
                  Is Modifierfalse
                  Must Supporttrue
                  Summarytrue
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  82. PractitionerRole.location
                  Definition

                  The location(s) at which this practitioner provides care.

                  ShortThe location(s) at which this practitioner provides care
                  Control0..*
                  This element is affected by the following invariants: us-core-13
                  TypeReference(NDH Base Location Profile)
                  Is Modifierfalse
                  Must Supporttrue
                  Summarytrue
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  84. PractitionerRole.healthcareService
                  Definition

                  The list of healthcare services that this worker provides for this role's Organization/Location(s).

                  ShortThe list of healthcare services that this worker provides for this role's Organization/Location(s)
                  Control0..*
                  This element is affected by the following invariants: us-core-13
                  TypeReference(NDH Base HealthcareService Profile)
                  Is Modifierfalse
                  Must Supporttrue
                  Summaryfalse
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  86. PractitionerRole.telecom
                  Definition

                  Contact details that are specific to the role/location/service.

                  ShortContact details that are specific to the role/location/service
                  Control0..*
                  This element is affected by the following invariants: pd-1
                  TypeContactPoint
                  Is Modifierfalse
                  Must Supporttrue
                  Summarytrue
                  Requirements

                  Often practitioners have a dedicated line for each location (or service) that they work at, and need to be able to define separate contact details for each of these.

                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  88. PractitionerRole.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
                  90. PractitionerRole.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 PractitionerRole.telecom.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                  • value @ url
                  • 92. PractitionerRole.telecom.extension:contactpoint-availabletime
                    Slice Namecontactpoint-availabletime
                    Definition

                    An extension representing the days and times a contact point is available

                    ShortNDH Contactpoint Availabletime
                    Control0..*
                    TypeExtension(NDH Contactpoint Availabletime) (Complex Extension)
                    Is Modifierfalse
                    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())
                    94. PractitionerRole.telecom.extension:via-intermediary
                    Slice Namevia-intermediary
                    Definition

                    A reference to an alternative point of contact (NdhPractitionerRole, NdhOrganization, NdhOrganizationAffiliation, or NdhLocation) for this organization

                    ShortVia Intermediary
                    Control0..1
                    TypeExtension(NDH Via Intermediary) (Extension Type: Reference(NDH Base PractitionerRole, NDH Base OrganizationAffiliation Profile, NDH Base Location Profile, NDH Base Organization Profile))
                    Is Modifierfalse
                    Summaryfalse
                    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())
                    96. PractitionerRole.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
                    Control1..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()))
                    98. PractitionerRole.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.

                    Control1..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()))
                    100. PractitionerRole.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()))
                    102. PractitionerRole.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()))
                    104. PractitionerRole.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()))
                    106. PractitionerRole.availableTime
                    Definition

                    A collection of times the practitioner is available or performing this role at the location and/or healthcareservice.

                    ShortTimes the Service Site is available
                    Comments

                    More detailed availability information may be provided in associated Schedule/Slot resources.

                    Control0..*
                    TypeBackboneElement
                    Is Modifierfalse
                    Summaryfalse
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    108. PractitionerRole.availableTime.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
                    110. PractitionerRole.availableTime.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())
                    112. PractitionerRole.availableTime.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())
                    114. PractitionerRole.availableTime.daysOfWeek
                    Definition

                    Indicates which days of the week are available between the start and end Times.

                    Shortmon | tue | wed | thu | fri | sat | sun
                    Control0..*
                    BindingThe codes SHALL be taken from DaysOfWeek
                    (required to http://hl7.org/fhir/ValueSet/days-of-week|4.0.1)

                    The days of the week.

                    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()))
                    116. PractitionerRole.availableTime.allDay
                    Definition

                    Is this always available? (hence times are irrelevant) e.g. 24 hour service.

                    ShortAlways available? e.g. 24 hour service
                    Control0..1
                    Typeboolean
                    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()))
                    118. PractitionerRole.availableTime.availableStartTime
                    Definition

                    The opening time of day. Note: If the AllDay flag is set, then this time is ignored.

                    ShortOpening time of day (ignored if allDay = true)
                    Comments

                    The timezone is expected to be for where this HealthcareService is provided at.

                    Control0..1
                    Typetime
                    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()))
                    120. PractitionerRole.availableTime.availableEndTime
                    Definition

                    The closing time of day. Note: If the AllDay flag is set, then this time is ignored.

                    ShortClosing time of day (ignored if allDay = true)
                    Comments

                    The timezone is expected to be for where this HealthcareService is provided at.

                    Control0..1
                    Typetime
                    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()))
                    122. PractitionerRole.notAvailable
                    Definition

                    The practitioner is not available or performing this role during this period of time due to the provided reason.

                    ShortNot available during this time due to provided reason
                    Control0..*
                    TypeBackboneElement
                    Is Modifierfalse
                    Summaryfalse
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    124. PractitionerRole.notAvailable.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
                    126. PractitionerRole.notAvailable.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())
                    128. PractitionerRole.notAvailable.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())
                    130. PractitionerRole.notAvailable.description
                    Definition

                    The reason that can be presented to the user as to why this time is not available.

                    ShortReason presented to the user explaining why time not available
                    Control1..1
                    Typestring
                    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()))
                    132. PractitionerRole.notAvailable.during
                    Definition

                    Service is not available (seasonally or for a public holiday) from this date.

                    ShortService not available from this date
                    Control0..1
                    TypePeriod
                    Is Modifierfalse
                    Summaryfalse
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    134. PractitionerRole.availabilityExceptions
                    Definition

                    A description of site availability exceptions, e.g. public holiday availability. Succinctly describing all possible exceptions to normal site availability as details in the available Times and not available Times.

                    ShortDescription of availability exceptions
                    Control0..1
                    Typestring
                    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()))
                    136. PractitionerRole.endpoint
                    Definition

                    Technical endpoints providing access to services operated for the practitioner with this role.

                    ShortTechnical endpoints providing access to services operated for the practitioner with this role
                    Control0..*
                    This element is affected by the following invariants: pd-1
                    TypeReference(NDH Base Endpoint Profile)
                    Is Modifierfalse
                    Must Supporttrue
                    Summaryfalse
                    Requirements

                    Organizations have multiple systems that provide various services and ,ay also be different for practitioners too.

                    So the endpoint satisfies the need to be able to define the technical connection details for how to connect to them, and for what purpose.

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