National Directory of Healthcare Providers & Services (NDH) Implementation Guide
1.0.0-ballot - ballot United States of America flag

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: NdhNdApiPractitioner - Detailed Descriptions

Active as of 2024-03-28

Definitions for the ndh-ndapi-Practitioner resource profile.

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

0. Practitioner
2. Practitioner.meta
Must Supporttrue
4. Practitioner.meta.profile
Control1..1
6. Practitioner.extension
Control1..?
8. Practitioner.extension:us-core-race
Slice Nameus-core-race
Must Supporttrue
10. Practitioner.extension:us-core-ethnicity
Slice Nameus-core-ethnicity
Must Supporttrue
12. Practitioner.extension:individual-genderIdentity
Slice Nameindividual-genderIdentity
Must Supporttrue
14. Practitioner.extension:individual-pronouns
Slice Nameindividual-pronouns
Must Supporttrue
16. Practitioner.extension:individual-recordedSexOrGender
Slice Nameindividual-recordedSexOrGender
Must Supporttrue
18. Practitioner.extension:endpoint
Slice Nameendpoint
Must Supporttrue
20. Practitioner.extension:endpoint.value[x]
TypeReference(National Directory API Endpoint Profile)
[x] NoteSee Choice of Data Types for further information about how to use [x]
22. Practitioner.extension:accessibility
Slice Nameaccessibility
Must Supporttrue
24. Practitioner.extension:digitalcertificate
Slice Namedigitalcertificate
Must Supporttrue
26. Practitioner.extension:rating
Slice Namerating
Must Supporttrue
28. Practitioner.extension:verification-status
Slice Nameverification-status
Control1..?
Must Supporttrue
30. Practitioner.identifier
NoteThis is a business identifier, not a resource identifier (see discussion)
32. Practitioner.identifier.extension
Control1..?
34. Practitioner.identifier.extension:identifier-status
Slice Nameidentifier-status
Control1..?
Must Supporttrue
36. Practitioner.identifier.use
Must Supporttrue
38. Practitioner.identifier.type
Must Supporttrue
40. Practitioner.identifier.assigner
TypeReference(National Directory API Organization Profile)
Must Supporttrue
42. Practitioner.active
Must Supporttrue
44. Practitioner.name
46. Practitioner.name.use
Must Supporttrue
48. Practitioner.name.given
Control1..?
Must Supporttrue
50. Practitioner.name.prefix
Must Supporttrue
52. Practitioner.name.suffix
Must Supporttrue
54. Practitioner.name.period
Must Supporttrue
56. Practitioner.telecom
58. Practitioner.telecom.extension:contactpoint-availabletime
Slice Namecontactpoint-availabletime
Must Supporttrue
60. Practitioner.telecom.extension:via-intermediary
Slice Namevia-intermediary
Must Supporttrue
62. Practitioner.telecom.system
Control1..?
64. Practitioner.telecom.value
Control1..?
66. Practitioner.telecom.use
Must Supporttrue
68. Practitioner.telecom.rank
Must Supporttrue
70. Practitioner.address
72. Practitioner.address.use
Must Supporttrue
74. Practitioner.address.type
Must Supporttrue
76. Practitioner.address.text
Must Supporttrue
78. Practitioner.gender
Must Supporttrue
80. Practitioner.birthDate
Must Supporttrue
82. Practitioner.photo
Must Supporttrue
84. Practitioner.qualification
86. Practitioner.qualification.extension:practitioner-qualification
Slice Namepractitioner-qualification
Must Supporttrue
88. Practitioner.qualification.identifier
NoteThis is a business identifier, not a resource identifier (see discussion)
Must Supporttrue
90. Practitioner.qualification.identifier.extension
Control1..?
92. Practitioner.qualification.identifier.extension:identifier-status
Slice Nameidentifier-status
Control1..?
Must Supporttrue
94. Practitioner.qualification.identifier.use
Must Supporttrue
96. Practitioner.qualification.identifier.type
Must Supporttrue
98. Practitioner.qualification.identifier.system
Must Supporttrue
100. Practitioner.qualification.identifier.value
Must Supporttrue
102. Practitioner.qualification.identifier.period
Must Supporttrue
104. Practitioner.qualification.identifier.assigner
TypeReference(National Directory API Organization Profile)
Must Supporttrue
106. Practitioner.qualification.code
Must Supporttrue
108. Practitioner.qualification.period
Must Supporttrue
110. Practitioner.communication
Must Supporttrue
112. Practitioner.communication.extension:communication-proficiency
Slice Namecommunication-proficiency
Must Supporttrue
114. Practitioner.communication.coding
Must Supporttrue
116. Practitioner.communication.text
Must Supporttrue

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

0. Practitioner
Definition

-


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

ShortA person with a formal responsibility in the provisioning of healthcare or related services
Comments

-

Control0..*
Is Modifierfalse
Must Supportfalse
Summaryfalse
Alternate NamesProvider
Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty())
dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
dom-6: A resource should have narrative for robust management (text.`div`.exists())
2. Practitioner.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
Must Supporttrue
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
4. Practitioner.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.

Control10..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()))
6. Practitioner.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.

Control10..1*
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()))
8. Practitioner.implicitRules
Definition

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

ShortA set of rules under which this content was created
Comments

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

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

Control10..*
TypeExtension
Is Modifierfalse
Summaryfalse
Alternate Namesextensions, user content
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
SlicingThis element introduces a set of slices on Practitioner.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
  • 12. Practitioner.extension:us-core-race
    Slice Nameus-core-race
    Definition

    Concepts classifying the person into a named category of humans sharing common history, traits, geographical origin or nationality. The race codes used to represent these concepts are based upon the CDC Race and Ethnicity Code Set Version 1.0 which includes over 900 concepts for representing race and ethnicity of which 921 reference race. The race concepts are grouped by and pre-mapped to the 5 OMB race categories:

    • American Indian or Alaska Native
    • Asian
    • Black or African American
    • Native Hawaiian or Other Pacific Islander
    • White.
    ShortUS Core Race Extension
    Control0..1
    This element is affected by the following invariants: ele-1
    TypeExtension(US Core Race Extension) (Complex Extension)
    Is Modifierfalse
    Must Supporttrue
    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())
    14. Practitioner.extension:us-core-ethnicity
    Slice Nameus-core-ethnicity
    Definition

    Concepts classifying the person into a named category of humans sharing common history, traits, geographical origin or nationality. The ethnicity codes used to represent these concepts are based upon the CDC ethnicity and Ethnicity Code Set Version 1.0 which includes over 900 concepts for representing race and ethnicity of which 43 reference ethnicity. The ethnicity concepts are grouped by and pre-mapped to the 2 OMB ethnicity categories: - Hispanic or Latino - Not Hispanic or Latino.

    ShortUS Core ethnicity Extension
    Control0..1
    This element is affected by the following invariants: ele-1
    TypeExtension(US Core Ethnicity Extension) (Complex Extension)
    Is Modifierfalse
    Must Supporttrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    16. Practitioner.extension:individual-genderIdentity
    Slice Nameindividual-genderIdentity
    Definition

    An individual's personal sense of being a man, woman, boy, girl, nonbinary, or something else.

    ShortThe individual's gender identity
    Comments

    This represents an individual’s identity, ascertained by asking them what that identity is.

    Control0..*
    TypeExtension(Individual Gender Identity) (Complex Extension)
    Is Modifierfalse
    Must Supporttrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    18. Practitioner.extension:individual-pronouns
    Slice Nameindividual-pronouns
    Definition

    The pronouns to use when referring to an individual in verbal or written communication.

    ShortThe pronouns to use when communicating about an individual.
    Control0..*
    TypeExtension(Individual Pronouns) (Complex Extension)
    Is Modifierfalse
    Must Supporttrue
    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())
    20. Practitioner.extension:individual-recordedSexOrGender
    Slice Nameindividual-recordedSexOrGender
    Definition

    A sex or gender property for the individual from a document or other record

    ShortA recorded sex or gender property for the individual
    Control0..*
    TypeExtension(Person Recorded Sex Or Gender) (Complex Extension)
    Is Modifierfalse
    Must Supporttrue
    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. Practitioner.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())
    24. Practitioner.extension:endpoint
    Slice Nameendpoint
    Definition

    The technical details of an endpoint that can be used for electronic services

    ShortNDH Endpoint Reference
    Control0..*
    This element is affected by the following invariants: ele-1
    TypeExtension(NDH Endpoint Reference) (Extension Type: Reference(NDH Base Endpoint Profile))
    Is Modifierfalse
    Must Supporttrue
    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())
    26. Practitioner.extension:endpoint.extension
    Definition

    An Extension


    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.

    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..0*
    TypeExtension
    Is Modifierfalse
    Summaryfalse
    Alternate Namesextensions, user content
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    SlicingThis element introduces a set of slices on Practitioner.extension.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
    • value @ url
    • 28. Practitioner.extension:endpoint.url
      Definition

      Source of the definition for the extension code - a logical name or a URL.

      Shortidentifies the meaning of the extension
      Comments

      The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

      Control1..1
      Typeuri
      Is Modifierfalse
      XML FormatIn the XML format, this property is represented as an attribute.
      Summaryfalse
      Fixed Valuehttp://hl7.org/fhir/us/ndh/StructureDefinition/base-ext-endpoint-reference
      30. Practitioner.extension:endpoint.value[x]
      Definition

      Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

      ShortValue of extension
      Control10..1
      TypeReference(National Directory API Endpoint Profile), date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, CodeableConcept, ParameterDefinition, dateTime, code, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
      [x] NoteSee Choice of Data Types for further information about how to use [x]
      Is Modifierfalse
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      32. Practitioner.extension:accessibility
      Slice Nameaccessibility
      Definition

      An extension to describe accessibility options offered by a practitioner or at a location.

      ShortNDH Accessibility
      Control0..*
      This element is affected by the following invariants: ele-1
      TypeExtension(NDH Accessibility) (Extension Type: CodeableConcept)
      Is Modifierfalse
      Must Supporttrue
      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())
      34. Practitioner.extension:digitalcertificate
      Slice Namedigitalcertificate
      Definition

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

      ShortNDH Digitalcertificate
      Control0..*
      This element is affected by the following invariants: ele-1
      TypeExtension(NDH Digitalcertificate) (Complex Extension)
      Is Modifierfalse
      Must Supporttrue
      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())
      36. Practitioner.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
      Must Supporttrue
      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. Practitioner.extension:verification-status
      Slice Nameverification-status
      Definition

      Indicates a resource instance verification status

      ShortNDH Verification Status
      Control1..1
      This element is affected by the following invariants: ele-1
      TypeExtension(NDH Verification Status) (Extension Type: CodeableConcept)
      Is Modifierfalse
      Must Supporttrue
      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())
      40. Practitioner.modifierExtension
      Definition

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

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

      ShortExtensions that cannot be ignored
      Comments

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

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

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

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

      An identifier that applies to this person in this role.

      ShortAn identifier for the person as this agent
      Comments

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

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

      Often, specific identities are assigned for the agent.

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

        An Extension


        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.

        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.

        Control10..*
        TypeExtension
        Is Modifierfalse
        Summaryfalse
        Alternate Namesextensions, user content
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        SlicingThis element introduces a set of slices on Practitioner.identifier.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
        • value @ url
        • 46. Practitioner.identifier.extension:identifier-status
          Slice Nameidentifier-status
          Definition

          Describes the status of an identifier

          ShortNDH Identifier Status
          Control1..1
          TypeExtension(NDH Identifier Status) (Extension Type: code)
          Is Modifierfalse
          Must Supporttrue
          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())
          48. Practitioner.identifier.use
          Definition

          The purpose of this identifier.

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

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

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

          Identifies the purpose for this identifier, if known .

          Typecode
          Is Modifiertrue because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supporttrue
          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()))
          50. Practitioner.identifier.type
          Definition

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

          ShortDescription of identifier
          Comments

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

          Control0..1
          BindingUnless not suitable, these codes SHALL be taken from Identifier Type Codeshttp://hl7.org/fhir/ValueSet/identifier-type
          (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
          Must Supporttrue
          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()))
          52. Practitioner.identifier.system
          Definition

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

          ShortThe namespace for the identifier value
          Comments

          Identifier.system is always case sensitive.

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

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

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

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

          ShortThe value that is unique
          Comments

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

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

          Organization that issued/manages the identifier.

          ShortOrganization that issued id (may be just text)
          Comments

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

          Control0..1
          TypeReference(National Directory API 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()))
          58. Practitioner.identifier:NPI
          Slice NameNPI
          Definition

          An identifier that applies to this person in this role.

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

          Often, specific identities are assigned for the agent.

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

          Whether this practitioner's record is in active use.

          ShortWhether this practitioner's record is in active use
          Comments

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

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

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

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

          The name(s) associated with the practitioner.

          ShortThe name(s) associated with the practitioner
          Comments

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

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

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

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

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

          Identifies the purpose for this name.

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

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

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

          The use of a human name.

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

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

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

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

          ShortText representation of the full name
          Comments

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

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

          A renderable, unencoded form.

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

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

          ShortFamily name (often called 'Surname')
          Comments

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

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

          Given name.

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

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

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

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

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

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

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

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

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

          Allows names to be placed in historical context.

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

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

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

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

          Control0..*
          TypeContactPoint
          Is Modifierfalse
          Must Supporttrue
          Summarytrue
          Requirements

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

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          80. Practitioner.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
          Must Supporttrue
          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())
          82. Practitioner.telecom.extension:via-intermediary
          Slice Namevia-intermediary
          Definition

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

          ShortNDH Via 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
          Must Supporttrue
          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())
          84. Practitioner.telecom.system
          Definition

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

          Shortphone | fax | email | pager | url | sms | other
          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()))
          86. Practitioner.telecom.value
          Definition

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

          ShortThe actual contact point details
          Comments

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

          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()))
          88. Practitioner.telecom.use
          Definition

          Identifies the purpose for the contact point.

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

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

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

          Use of contact point.

          Typecode
          Is Modifiertrue because This is labeled as "Is Modifier" because applications should not mistake a temporary or old contact etc.for a current/permanent one
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supporttrue
          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()))
          90. Practitioner.telecom.rank
          Definition

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

          ShortSpecify preferred order of use (1 = highest)
          Comments

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

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

          Address(es) of the practitioner


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

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

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

          Control0..*
          TypeAddress
          Is Modifierfalse
          Must Supporttrue
          Summarytrue
          Requirements

          -


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

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

          The absolute geographic location of the Location, expressed using the WGS84 datum (This is the same co-ordinate system used in KML).

          ShortThe absolute geographic location
          Comments

          The extension can be further extended to include unique geolocation identifiers, confidence, altitude, etc.

          Control0..1
          TypeExtension(Geolocation) (Complex Extension)
          Is Modifierfalse
          Must Supporttrue
          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. Practitioner.address.use
          Definition

          The purpose of this address.

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

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

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

          The use of an address.

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

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

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

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

          Shortpostal | physical | both
          Comments

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


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

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

          The type of an address (physical / postal).

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

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

          ShortText representation of the address
          Comments

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

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

          A renderable, unencoded form.

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

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

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

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

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

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

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

          Two letter USPS alphabetic codes.

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

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

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

          Country - a nation as commonly understood or generally accepted.

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

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

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

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

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

          The gender of a person used for administrative purposes.

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

          Needed to address the person correctly.

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

          The date of birth for the practitioner.

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

          Needed for identification.

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

          Image of the person.

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

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

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

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

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

          An extension to add status and whereValid elements to a practitioner’s qualifications.

          ShortNDH Practitioner Qualification
          Control0..1
          This element is affected by the following invariants: ele-1
          TypeExtension(NDH Practitioner Qualification) (Complex Extension)
          Is Modifierfalse
          Must Supporttrue
          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())
          122. Practitioner.qualification.modifierExtension
          Definition

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

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

          ShortExtensions that cannot be ignored even if unrecognized
          Comments

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

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

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

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

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

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

          Often, specific identities are assigned for the qualification.

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

          An Extension


          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.

          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.

          Control10..*
          TypeExtension
          Is Modifierfalse
          Summaryfalse
          Alternate Namesextensions, user content
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          SlicingThis element introduces a set of slices on Practitioner.qualification.identifier.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
          • value @ url
          • 128. Practitioner.qualification.identifier.extension:identifier-status
            Slice Nameidentifier-status
            Definition

            Describes the status of an identifier

            ShortNDH Identifier Status
            Control1..1
            TypeExtension(NDH Identifier Status) (Extension Type: code)
            Is Modifierfalse
            Must Supporttrue
            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())
            130. Practitioner.qualification.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
            Must Supporttrue
            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()))
            132. Practitioner.qualification.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 Codeshttp://hl7.org/fhir/ValueSet/identifier-type
            (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
            Must Supporttrue
            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()))
            134. Practitioner.qualification.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
            Must Supporttrue
            Summarytrue
            Requirements

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

            Example<br/><b>General</b>:http://www.acme.com/identifiers/patient
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            136. Practitioner.qualification.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
            Must Supporttrue
            Summarytrue
            Example<br/><b>General</b>:123456
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            138. Practitioner.qualification.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
            Must Supporttrue
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            140. Practitioner.qualification.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(National Directory API 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()))
            142. Practitioner.qualification.code
            Definition

            Coded representation of the qualification.

            ShortCoded representation of the qualification
            Control1..1
            BindingUnless not suitable, these codes SHALL be taken from For example codes, see Individual Specialties, Degrees, Licenses, and Certificates Value Sethttp://terminology.hl7.org/ValueSet/v2-2.7-0360
            (extensible to http://hl7.org/fhir/us/ndh/ValueSet/IndividualSpecialtyAndDegreeLicenseCertificateVS)
            TypeCodeableConcept
            Is Modifierfalse
            Must Supporttrue
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            144. Practitioner.qualification.period
            Definition

            Period during which the qualification is valid.

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

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

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

            Organization that regulates and issues the qualification.

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

            A language the practitioner can use in patient communication.

            ShortA language the practitioner can use in patient communication
            Comments

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

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

            A human language.

            Additional BindingsPurpose
            AllLanguagesMax Binding
            TypeCodeableConcept
            Is Modifierfalse
            Must Supporttrue
            Summaryfalse
            Requirements

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

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            150. Practitioner.communication.extension:communication-proficiency
            Slice Namecommunication-proficiency
            Definition

            An extension to express a practitioner’s spoken proficiency with the language indicated in practitioner.communication.

            ShortNDH Communication Proficiency
            Control0..1
            TypeExtension(NDH Communication Proficiency) (Extension Type: CodeableConcept)
            Is Modifierfalse
            Must Supporttrue
            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())
            152. Practitioner.communication.coding
            Definition

            A reference to a code defined by a terminology system.

            ShortCode defined by a terminology system
            Comments

            Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

            Control0..*
            TypeCoding
            Is Modifierfalse
            Must Supporttrue
            Summarytrue
            Requirements

            Allows for alternative encodings within a code system, and translations to other code systems.

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

            A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

            ShortPlain text representation of the concept
            Comments

            Very often the text is the same as a displayName of one of the codings.

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

            The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

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

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

            0. Practitioner
            Definition

            -

            ShortA person with a formal responsibility in the provisioning of healthcare or related services
            Comments

            -

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

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

            ShortLogical id of this artifact
            Comments

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

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

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

            ShortMetadata about the resource
            Control0..1
            TypeMeta
            Is Modifierfalse
            Must Supporttrue
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            6. Practitioner.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. Practitioner.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 Practitioner.meta.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
            • value @ url
            • 10. Practitioner.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. Practitioner.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. Practitioner.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. Practitioner.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.

              Control1..1
              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. Practitioner.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. Practitioner.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. Practitioner.implicitRules
              Definition

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

              ShortA set of rules under which this content was created
              Comments

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

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

              The base language in which the resource is written.

              ShortLanguage of the resource content
              Comments

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

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

              A human language.

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

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

              ShortText summary of the resource, for human interpretation
              Comments

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

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

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

              ShortContained, inline Resources
              Comments

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

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

              An Extension

              ShortExtension
              Control1..*
              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 Practitioner.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
              • value @ url
              • 32. Practitioner.extension:us-core-race
                Slice Nameus-core-race
                Definition

                Concepts classifying the person into a named category of humans sharing common history, traits, geographical origin or nationality. The race codes used to represent these concepts are based upon the CDC Race and Ethnicity Code Set Version 1.0 which includes over 900 concepts for representing race and ethnicity of which 921 reference race. The race concepts are grouped by and pre-mapped to the 5 OMB race categories:

                • American Indian or Alaska Native
                • Asian
                • Black or African American
                • Native Hawaiian or Other Pacific Islander
                • White.
                ShortUS Core Race Extension
                Control0..1
                This element is affected by the following invariants: ele-1
                TypeExtension(US Core Race Extension) (Complex Extension)
                Is Modifierfalse
                Must Supporttrue
                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. Practitioner.extension:us-core-ethnicity
                Slice Nameus-core-ethnicity
                Definition

                Concepts classifying the person into a named category of humans sharing common history, traits, geographical origin or nationality. The ethnicity codes used to represent these concepts are based upon the CDC ethnicity and Ethnicity Code Set Version 1.0 which includes over 900 concepts for representing race and ethnicity of which 43 reference ethnicity. The ethnicity concepts are grouped by and pre-mapped to the 2 OMB ethnicity categories: - Hispanic or Latino - Not Hispanic or Latino.

                ShortUS Core ethnicity Extension
                Control0..1
                This element is affected by the following invariants: ele-1
                TypeExtension(US Core Ethnicity Extension) (Complex Extension)
                Is Modifierfalse
                Must Supporttrue
                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())
                36. Practitioner.extension:individual-genderIdentity
                Slice Nameindividual-genderIdentity
                Definition

                An individual's personal sense of being a man, woman, boy, girl, nonbinary, or something else.

                ShortThe individual's gender identity
                Comments

                This represents an individual’s identity, ascertained by asking them what that identity is.

                Control0..*
                TypeExtension(Individual Gender Identity) (Complex Extension)
                Is Modifierfalse
                Must Supporttrue
                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. Practitioner.extension:individual-pronouns
                Slice Nameindividual-pronouns
                Definition

                The pronouns to use when referring to an individual in verbal or written communication.

                ShortThe pronouns to use when communicating about an individual.
                Control0..*
                TypeExtension(Individual Pronouns) (Complex Extension)
                Is Modifierfalse
                Must Supporttrue
                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. Practitioner.extension:individual-recordedSexOrGender
                Slice Nameindividual-recordedSexOrGender
                Definition

                A sex or gender property for the individual from a document or other record

                ShortA recorded sex or gender property for the individual
                Control0..*
                TypeExtension(Person Recorded Sex Or Gender) (Complex Extension)
                Is Modifierfalse
                Must Supporttrue
                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. Practitioner.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())
                44. Practitioner.extension:endpoint
                Slice Nameendpoint
                Definition

                The technical details of an endpoint that can be used for electronic services

                ShortNDH Endpoint Reference
                Control0..*
                This element is affected by the following invariants: ele-1
                TypeExtension(NDH Endpoint Reference) (Extension Type: Reference(NDH Base Endpoint Profile))
                Is Modifierfalse
                Must Supporttrue
                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. Practitioner.extension:endpoint.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
                48. Practitioner.extension:endpoint.extension
                Definition

                An Extension

                ShortExtension
                Control0..0
                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 Practitioner.extension.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
                • value @ url
                • 50. Practitioner.extension:endpoint.url
                  Definition

                  Source of the definition for the extension code - a logical name or a URL.

                  Shortidentifies the meaning of the extension
                  Comments

                  The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

                  Control1..1
                  Typeuri
                  Is Modifierfalse
                  XML FormatIn the XML format, this property is represented as an attribute.
                  Summaryfalse
                  Fixed Valuehttp://hl7.org/fhir/us/ndh/StructureDefinition/base-ext-endpoint-reference
                  52. Practitioner.extension:endpoint.value[x]
                  Definition

                  Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

                  ShortValue of extension
                  Control1..1
                  TypeReference(National Directory API Endpoint Profile)
                  [x] NoteSee Choice of Data Types for further information about how to use [x]
                  Is Modifierfalse
                  Summaryfalse
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  54. Practitioner.extension:accessibility
                  Slice Nameaccessibility
                  Definition

                  An extension to describe accessibility options offered by a practitioner or at a location.

                  ShortNDH Accessibility
                  Control0..*
                  This element is affected by the following invariants: ele-1
                  TypeExtension(NDH Accessibility) (Extension Type: CodeableConcept)
                  Is Modifierfalse
                  Must Supporttrue
                  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. Practitioner.extension:digitalcertificate
                  Slice Namedigitalcertificate
                  Definition

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

                  ShortNDH Digitalcertificate
                  Control0..*
                  This element is affected by the following invariants: ele-1
                  TypeExtension(NDH Digitalcertificate) (Complex Extension)
                  Is Modifierfalse
                  Must Supporttrue
                  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())
                  58. Practitioner.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
                  Must Supporttrue
                  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())
                  60. Practitioner.extension:verification-status
                  Slice Nameverification-status
                  Definition

                  Indicates a resource instance verification status

                  ShortNDH Verification Status
                  Control1..1
                  This element is affected by the following invariants: ele-1
                  TypeExtension(NDH Verification Status) (Extension Type: CodeableConcept)
                  Is Modifierfalse
                  Must Supporttrue
                  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())
                  62. Practitioner.modifierExtension
                  Definition

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

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

                  ShortExtensions that cannot be ignored
                  Comments

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

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

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

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

                  An identifier that applies to this person in this role.

                  ShortAn identifier for the person as this agent
                  Comments

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

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

                  Often, specific identities are assigned for the agent.

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

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

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

                    An Extension

                    ShortExtension
                    Control1..*
                    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 Practitioner.identifier.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
                    • value @ url
                    • 70. Practitioner.identifier.extension:identifier-status
                      Slice Nameidentifier-status
                      Definition

                      Describes the status of an identifier

                      ShortNDH Identifier Status
                      Control1..1
                      TypeExtension(NDH Identifier Status) (Extension Type: code)
                      Is Modifierfalse
                      Must Supporttrue
                      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())
                      72. Practitioner.identifier.use
                      Definition

                      The purpose of this identifier.

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

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

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

                      Identifies the purpose for this identifier, if known .

                      Typecode
                      Is Modifiertrue because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      Must Supporttrue
                      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()))
                      74. Practitioner.identifier.type
                      Definition

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

                      ShortDescription of identifier
                      Comments

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

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

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

                      TypeCodeableConcept
                      Is Modifierfalse
                      Must Supporttrue
                      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()))
                      76. Practitioner.identifier.system
                      Definition

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

                      ShortThe namespace for the identifier value
                      Comments

                      Identifier.system is always case sensitive.

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

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

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

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

                      ShortThe value that is unique
                      Comments

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

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

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

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

                      Organization that issued/manages the identifier.

                      ShortOrganization that issued id (may be just text)
                      Comments

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

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

                      An identifier that applies to this person in this role.

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

                      Often, specific identities are assigned for the agent.

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

                      Whether this practitioner's record is in active use.

                      ShortWhether this practitioner's record is in active use
                      Comments

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

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

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

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

                      The name(s) associated with the practitioner.

                      ShortThe name(s) associated with the practitioner
                      Comments

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

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

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

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

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

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

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

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

                      ShortAdditional content defined by implementations
                      Comments

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

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

                        Identifies the purpose for this name.

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

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

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

                        The use of a human name.

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

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

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

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

                        ShortText representation of the full name
                        Comments

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

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

                        A renderable, unencoded form.

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

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

                        ShortFamily name (often called 'Surname')
                        Comments

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

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

                        Given name.

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

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

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

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

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

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

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

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

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

                        Allows names to be placed in historical context.

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

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

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

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

                        Control0..*
                        TypeContactPoint
                        Is Modifierfalse
                        Must Supporttrue
                        Summarytrue
                        Requirements

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

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

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

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

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

                        ShortAdditional content defined by implementations
                        Comments

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

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

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

                          ShortNDH Via 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
                          Must Supporttrue
                          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())
                          118. Practitioner.telecom.system
                          Definition

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

                          Shortphone | fax | email | pager | url | sms | other
                          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()))
                          120. Practitioner.telecom.value
                          Definition

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

                          ShortThe actual contact point details
                          Comments

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

                          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()))
                          122. Practitioner.telecom.use
                          Definition

                          Identifies the purpose for the contact point.

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

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

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

                          Use of contact point.

                          Typecode
                          Is Modifiertrue because This is labeled as "Is Modifier" because applications should not mistake a temporary or old contact etc.for a current/permanent one
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Must Supporttrue
                          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()))
                          124. Practitioner.telecom.rank
                          Definition

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

                          ShortSpecify preferred order of use (1 = highest)
                          Comments

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

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

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

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

                          Address(es) of the practitioner

                          ShortAddress(es) of the practitioner
                          Comments

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

                          Control0..*
                          TypeAddress
                          Is Modifierfalse
                          Must Supporttrue
                          Summarytrue
                          Requirements

                          -

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

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

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

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

                          ShortAdditional content defined by implementations
                          Comments

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

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

                            The absolute geographic location of the Location, expressed using the WGS84 datum (This is the same co-ordinate system used in KML).

                            ShortThe absolute geographic location
                            Comments

                            The extension can be further extended to include unique geolocation identifiers, confidence, altitude, etc.

                            Control0..1
                            TypeExtension(Geolocation) (Complex Extension)
                            Is Modifierfalse
                            Must Supporttrue
                            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())
                            136. Practitioner.address.use
                            Definition

                            The purpose of this address.

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

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

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

                            The use of an address.

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

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

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

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

                            Shortpostal | physical | both
                            Comments

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

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

                            The type of an address (physical / postal).

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

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

                            ShortText representation of the address
                            Comments

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

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

                            A renderable, unencoded form.

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

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

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

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

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

                            The name of the administrative area (county).

                            ShortDistrict name (aka county)
                            Comments

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

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

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

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

                            Two letter USPS alphabetic codes.

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

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

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

                            Country - a nation as commonly understood or generally accepted.

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

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

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

                            Time period when address was/is in use.

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

                            Allows addresses to be placed in historical context.

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

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

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

                            The gender of a person used for administrative purposes.

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

                            Needed to address the person correctly.

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

                            The date of birth for the practitioner.

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

                            Needed for identification.

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

                            Image of the person.

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

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

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

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

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

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

                            ShortUnique id for inter-element referencing
                            Control0..1
                            Typestring
                            Is Modifierfalse
                            XML FormatIn the XML format, this property is represented as an attribute.
                            Summaryfalse
                            166. Practitioner.qualification.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 Practitioner.qualification.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
                            • value @ url
                            • 168. Practitioner.qualification.extension:practitioner-qualification
                              Slice Namepractitioner-qualification
                              Definition

                              An extension to add status and whereValid elements to a practitioner’s qualifications.

                              ShortNDH Practitioner Qualification
                              Control0..1
                              This element is affected by the following invariants: ele-1
                              TypeExtension(NDH Practitioner Qualification) (Complex Extension)
                              Is Modifierfalse
                              Must Supporttrue
                              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())
                              170. Practitioner.qualification.modifierExtension
                              Definition

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

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

                              ShortExtensions that cannot be ignored even if unrecognized
                              Comments

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

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

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

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

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

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

                              Often, specific identities are assigned for the qualification.

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

                              An Extension

                              ShortExtension
                              Control1..*
                              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 Practitioner.qualification.identifier.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
                              • value @ url
                              • 178. Practitioner.qualification.identifier.extension:identifier-status
                                Slice Nameidentifier-status
                                Definition

                                Describes the status of an identifier

                                ShortNDH Identifier Status
                                Control1..1
                                TypeExtension(NDH Identifier Status) (Extension Type: code)
                                Is Modifierfalse
                                Must Supporttrue
                                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())
                                180. Practitioner.qualification.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
                                Must Supporttrue
                                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()))
                                182. Practitioner.qualification.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
                                Must Supporttrue
                                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()))
                                184. Practitioner.qualification.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
                                Must Supporttrue
                                Summarytrue
                                Requirements

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

                                Example<br/><b>General</b>:http://www.acme.com/identifiers/patient
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                186. Practitioner.qualification.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
                                Must Supporttrue
                                Summarytrue
                                Example<br/><b>General</b>:123456
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                188. Practitioner.qualification.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
                                Must Supporttrue
                                Summarytrue
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                190. Practitioner.qualification.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(National Directory API Organization Profile)
                                Is Modifierfalse
                                Must Supporttrue
                                Summarytrue
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                192. Practitioner.qualification.code
                                Definition

                                Coded representation of the qualification.

                                ShortCoded representation of the qualification
                                Control1..1
                                BindingUnless not suitable, these codes SHALL be taken from Individual Specialties, Degrees, Licenses, and Certificates Value Set
                                (extensible to http://hl7.org/fhir/us/ndh/ValueSet/IndividualSpecialtyAndDegreeLicenseCertificateVS)
                                TypeCodeableConcept
                                Is Modifierfalse
                                Must Supporttrue
                                Summaryfalse
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                194. Practitioner.qualification.period
                                Definition

                                Period during which the qualification is valid.

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

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

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

                                Organization that regulates and issues the qualification.

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

                                A language the practitioner can use in patient communication.

                                ShortA language the practitioner can use in patient communication
                                Comments

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

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

                                A human language.

                                Additional BindingsPurpose
                                AllLanguagesMax Binding
                                TypeCodeableConcept
                                Is Modifierfalse
                                Must Supporttrue
                                Summaryfalse
                                Requirements

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

                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                200. Practitioner.communication.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
                                202. Practitioner.communication.extension
                                Definition

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

                                ShortAdditional content defined by implementations
                                Comments

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

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

                                  An extension to express a practitioner’s spoken proficiency with the language indicated in practitioner.communication.

                                  ShortNDH Communication Proficiency
                                  Control0..1
                                  TypeExtension(NDH Communication Proficiency) (Extension Type: CodeableConcept)
                                  Is Modifierfalse
                                  Must Supporttrue
                                  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())
                                  206. Practitioner.communication.coding
                                  Definition

                                  A reference to a code defined by a terminology system.

                                  ShortCode defined by a terminology system
                                  Comments

                                  Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

                                  Control0..*
                                  TypeCoding
                                  Is Modifierfalse
                                  Must Supporttrue
                                  Summarytrue
                                  Requirements

                                  Allows for alternative encodings within a code system, and translations to other code systems.

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

                                  A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

                                  ShortPlain text representation of the concept
                                  Comments

                                  Very often the text is the same as a displayName of one of the codings.

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

                                  The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

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