US Core Implementation Guide
8.0.1 - STU 8 US

US Core Implementation Guide, published by HL7 International / Cross-Group Projects. This guide is not an authorized publication; it is the continuous build for version 8.0.1 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/US-Core/ and changes regularly. See the Directory of published versions

## Resource Profile: US Core Practitioner Profile

Official URL: http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitioner | Version: 8.0.1
Standards status: Trial-use | Maturity Level: 3 | Computable Name: USCorePractitionerProfile
Other Identifiers: OID:2.16.840.1.113883.4.642.40.2.42.49
Copyright/Legal: Used by permission of HL7 International, all rights reserved Creative Commons License

The US Core Practitioner Profile inherits from the FHIR Practitioner resource; refer to it for scope and usage definitions. This profile sets minimum expectations for the Practitioner resource to record, search, and fetch basic demographics and administrative information about an individual practitioner. It specifies which core elements, extensions, vocabularies, and value sets SHALL be present and constrains how the elements are used. Providing the floor for standards development for specific use cases promotes interoperability and adoption.

Example Usage Scenarios:

The following are example usage scenarios for this profile:

- Query for a practitioner by name or NPI
- Reference from other Resources

### Mandatory and Must Support Data Elements

The following data elements must always be present (Mandatory definition) or must be supported if the data is present in the sending system (Must Support definition). They are presented below in a simple human-readable explanation. Profile specific guidance and examples are provided as well. The Formal Views below provides the formal summary, definitions, and terminology requirements.

Each Practitioner Must Have:

1. An identifier that Must Support a National Provider Identifier (NPI) if available*

2. A name

Each PractitionerRole Must Support:

1. Contact information*
2. An address*

* see guidance below

Profile Specific Implementation Guidance:

- *Other identifiers beyond NPI, such as the National Council of State Boards of Nursing Identifier (NCSBN ID), may be used to uniquely refer to a practitioner when appropriate.
- *The Practitioner and PractitionerRole directly and indirectly communicate the address(es) and contact information of the practitioner. Servers that support only the US Core Practitioner Profile and do not support the US Core PractitionerRole Profile SHALL provide implementation-specific guidance on how to access a provider's location and contact information using only the Practitioner resource.
  - Although `Practitioner.address` is marked as Must Support, the Server system is not required to support it if they support the US Core PractitionerRole Profile, but SHALL support it if they do not support the US Core PractitionerRole Profile. The Client application SHALL support both.
- It is important to balance the privacy of healthcare workers with the patient's right to access information. Only professional/work contact information about the practitioner SHOULD be available to the patient (such as a work address or office telephone number).
- This profile may be referenced by different capability statements, such as the Conformance requirements for the US Core Server or a provider directory capability statement.
- * Systems SHOULD follow the Project US@ Technical Specification for Patient Addresses Final Version 1.0 as the standard style guide for `Practitioner.address.line` and `Practitioner.address.city`.

Usages:

- Refer to this Profile: US Core ADI DocumentReference Profile, US Core AllergyIntolerance Profile, US Core Average Blood Pressure Profile, US Core Care Experience Preference Profile... Show 27 more, US Core CarePlan Profile, US Core CareTeam Profile, US Core Condition Encounter Diagnosis Profile, US Core Condition Problems and Health Concerns Profile, US Core DiagnosticReport Profile for Laboratory Results Reporting, US Core DiagnosticReport Profile for Report and Note Exchange, US Core DocumentReference Profile, US Core Encounter Profile, US Core Goal Profile, US Core Immunization Profile, US Core MedicationDispense Profile, US Core MedicationRequest Profile, US Core Observation ADI Documentation Profile, US Core Observation Clinical Result Profile, US Core Observation Occupation Profile, US Core Observation Pregnancy Intent Profile, US Core Observation Pregnancy Status Profile, US Core Observation Screening Assessment Profile, US Core PractitionerRole Profile, US Core Procedure Profile, US Core Provenance Profile, US Core QuestionnaireResponse Profile, US Core ServiceRequest Profile, US Core Simple Observation Profile, US Core Smoking Status Observation Profile, US Core Treatment Intervention Preference Profile and US Core Vital Signs Profile
- Examples for this Profile: Practitioner/practitioner-1, Practitioner/practitioner-2 and Practitioner/practitioner-pharmacist
- CapabilityStatements using this Profile: US Core Client CapabilityStatement and US Core Server CapabilityStatement

You can also check for usages in the FHIR IG Statistics

Changes since version 7.0.0:

- The data elements list has changed

### Formal Views of Profile Content

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

- Key Elements Table
- Differential Table
- Snapshot Table
- Statistics/References
- All

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Practitioner |  | 0..* | Practitioner | A person with a formal responsibility in the provisioning of healthcare or related services
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
Slices for identifier | S Σ | 1..* | Identifier | An identifier for the person as this agent Slice: Unordered, Open by value:$this
identifier:All Slices |  |  |  | Content/Rules for all slices
use | ?!Σ | 0..1 | code | usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
system | S Σ | 1..1 | uri | The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
value | S Σ | 1..1 | string | The value that is unique Example General: 123456
identifier:NPI | S Σ C | 0..* | Identifier | An identifier for the person as this agent Constraints: us-core-16, us-core-17 Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
type |  | 0..1 | CodeableConcept | Description of identifier
period |  | 0..1 | Period | Time period when id is/was valid for use
assigner |  | 0..1 | Reference(Organization) | Organization that issued id (may be just text)
use | ?!Σ | 0..1 | code | usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
system | S Σ | 1..1 | uri | The namespace for the identifier value Fixed Value: http://hl7.org/fhir/sid/us-npi
value | S Σ | 1..1 | string | The value that is unique Example General: 123456
name | S Σ | 1..* | HumanName | The name(s) associated with the practitioner
use | ?!Σ | 0..1 | code | usual | official | temp | nickname | anonymous | old | maiden Binding: NameUse (required): The use of a human name.
family | S Σ | 1..1 | string | Family name (often called 'Surname')
telecom | S Σ | 0..* | ContactPoint | A contact detail for the practitioner (that apply to all roles)
system | S Σ C | 0..1 | code | phone | fax | email | pager | url | sms | other Binding: ContactPointSystem (required): Telecommunications form for contact point.
value | S Σ | 0..1 | string | The actual contact point details
use | ?!Σ | 0..1 | code | home | work | temp | old | mobile - purpose of this contact point Binding: ContactPointUse (required): Use of contact point.
address | S Σ | 0..* | Address | Address(es) of the practitioner
use | ?!Σ | 0..1 | code | home | work | temp | old | billing - purpose of this address Binding: AddressUse (required): The use of an address. Example General: home
line | S Σ | 0..4 | string | Street name, number, direction & P.O. Box etc. This repeating element order: The order in which lines should appear in an address label Example General: 137 Nowhere Street Example US Core: 49 MEADOW ST
city | S Σ | 0..1 | string | Name of city, town etc. Example General: Erewhon Example US Core: EVERYTOWN
state | S Σ | 0..1 | string | Sub-unit of country (abbreviations ok) Binding: USPS Two Letter Alphabetic Codes (extensible): Two letter USPS alphabetic codes. Example US Core: OK
postalCode | S Σ | 0..1 | string | US Zip Codes Example General: 9132 Example US Core: 74047
country | S Σ | 0..1 | string | Country (e.g. can be ISO 3166 2 or 3 letter code)
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
Practitioner.identifier.​use | Base | required | IdentifierUse | 📍4.0.1 | FHIR Std.
Practitioner.identifier:NPI.​use | Base | required | IdentifierUse | 📍4.0.1 | FHIR Std.
Practitioner.name.use | Base | required | NameUse | 📍4.0.1 | FHIR Std.
Practitioner.telecom.​system | Base | required | ContactPointSystem | 📍4.0.1 | FHIR Std.
Practitioner.telecom.​use | Base | required | ContactPointUse | 📍4.0.1 | FHIR Std.
Practitioner.address.​use | Base | required | AddressUse | 📍4.0.1 | FHIR Std.
Practitioner.address.​state | Base | extensible | USPS Two Letter Alphabetic Codes | 📦1.0.0 | THO v7.1

#### Constraints

Id | Grade | Path(s) | Description | Expression
dom-2 | error | Practitioner | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | Practitioner | 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 | error | Practitioner | 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 | error | Practitioner | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | Practitioner | A resource should have narrative for robust management | `text.`div`.exists()`
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children | `hasValue() or (children().count() > id.count())`
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`
us-core-16 | error | Practitioner.identifier:NPI | NPI must be 10 digits | `value.matches('^[0-9]{10}$')`
us-core-17 | error | Practitioner.identifier:NPI | NPI check digit must be valid (Luhn algorithm check) | `(((select(value.substring(0,1).toInteger()).select(iif($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)`

This structure is derived from Practitioner

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Practitioner |  | 0..* | Practitioner | A person with a formal responsibility in the provisioning of healthcare or related services
Slices for identifier | S | 1..* | Identifier | An identifier for the person as this agent Slice: Unordered, Open by value:$this
identifier:All Slices |  |  |  | Content/Rules for all slices
system | S | 1..1 | uri | The namespace for the identifier value
value | S | 1..1 | string | The value that is unique
identifier:NPI | S C | 0..* | Identifier | An identifier for the person as this agent Constraints: us-core-16, us-core-17 Required Pattern: At least the following
system |  | 1..1 | uri | The namespace for the identifier value Fixed Value: http://hl7.org/fhir/sid/us-npi
name | S | 1..* | HumanName | The name(s) associated with the practitioner
family | S | 1..1 | string | Family name (often called 'Surname')
telecom | S | 0..* | ContactPoint | A contact detail for the practitioner (that apply to all roles)
system | S | 0..1 | code | phone | fax | email | pager | url | sms | other
value | S | 0..1 | string | The actual contact point details
address | S | 0..* | Address | Address(es) of the practitioner
line | S | 0..4 | string | Street name, number, direction & P.O. Box etc. Example US Core: 49 MEADOW ST
city | S | 0..1 | string | Name of city, town etc. Example US Core: EVERYTOWN
state | S | 0..1 | string | Sub-unit of country (abbreviations ok) Binding: USPS Two Letter Alphabetic Codes (extensible): Two letter USPS alphabetic codes. Example US Core: OK
postalCode | S | 0..1 | string | US Zip Codes Example US Core: 74047
country | S | 0..1 | string | Country (e.g. can be ISO 3166 2 or 3 letter code)
Documentation for this format

#### Terminology Bindings (Differential)

Path | Status | Usage | ValueSet | Version | Source
Practitioner.address.​state | Base | extensible | USPS Two Letter Alphabetic Codes | 📦1.0.0 | THO v7.1

#### Constraints

Id | Grade | Path(s) | Description | Expression
us-core-16 | error | Practitioner.identifier:NPI | NPI must be 10 digits | `value.matches('^[0-9]{10}$')`
us-core-17 | error | Practitioner.identifier:NPI | NPI check digit must be valid (Luhn algorithm check) | `(((select(value.substring(0,1).toInteger()).select(iif($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)`

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Practitioner |  | 0..* | Practitioner | A person with a formal responsibility in the provisioning of healthcare or related services
id | Σ | 0..1 | id | Logical id of this artifact
meta | Σ | 0..1 | Meta | Metadata about the resource
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
language |  | 0..1 | code | Language of the resource content Binding: CommonLanguages (preferred): A human language.
Additional Bindings | Purpose
AllLanguages | Max Binding
text |  | 0..1 | Narrative | Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained |  | 0..* | Resource | Contained, inline Resources
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
Slices for identifier | S Σ | 1..* | Identifier | An identifier for the person as this agent Slice: Unordered, Open by value:$this
identifier:All Slices |  |  |  | Content/Rules for all slices
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
use | ?!Σ | 0..1 | code | usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type | Σ | 0..1 | CodeableConcept | Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
system | S Σ | 1..1 | uri | The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
value | S Σ | 1..1 | string | The value that is unique Example General: 123456
period | Σ | 0..1 | Period | Time period when id is/was valid for use
assigner | Σ | 0..1 | Reference(Organization) | Organization that issued id (may be just text)
identifier:NPI | S Σ C | 0..* | Identifier | An identifier for the person as this agent Constraints: us-core-16, us-core-17 Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
use | ?!Σ | 0..1 | code | usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type | Σ | 0..1 | CodeableConcept | Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
system | S Σ | 1..1 | uri | The namespace for the identifier value Fixed Value: http://hl7.org/fhir/sid/us-npi
value | S Σ | 1..1 | string | The value that is unique Example General: 123456
period | Σ | 0..1 | Period | Time period when id is/was valid for use
assigner | Σ | 0..1 | Reference(Organization) | Organization that issued id (may be just text)
active | Σ | 0..1 | boolean | Whether this practitioner's record is in active use
name | S Σ | 1..* | HumanName | The name(s) associated with the practitioner
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
use | ?!Σ | 0..1 | code | usual | official | temp | nickname | anonymous | old | maiden Binding: NameUse (required): The use of a human name.
text | Σ | 0..1 | string | Text representation of the full name
family | S Σ | 1..1 | string | Family name (often called 'Surname')
given | Σ | 0..* | string | Given names (not always 'first'). Includes middle names This repeating element order: Given Names appear in the correct order for presenting the name
prefix | Σ | 0..* | string | Parts that come before the name This repeating element order: Prefixes appear in the correct order for presenting the name
suffix | Σ | 0..* | string | Parts that come after the name This repeating element order: Suffixes appear in the correct order for presenting the name
period | Σ | 0..1 | Period | Time period when name was/is in use
telecom | S Σ | 0..* | ContactPoint | A contact detail for the practitioner (that apply to all roles)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
system | S Σ C | 0..1 | code | phone | fax | email | pager | url | sms | other Binding: ContactPointSystem (required): Telecommunications form for contact point.
value | S Σ | 0..1 | string | The actual contact point details
use | ?!Σ | 0..1 | code | home | work | temp | old | mobile - purpose of this contact point Binding: ContactPointUse (required): Use of contact point.
rank | Σ | 0..1 | positiveInt | Specify preferred order of use (1 = highest)
period | Σ | 0..1 | Period | Time period when the contact point was/is in use
address | S Σ | 0..* | Address | Address(es) of the practitioner
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
use | ?!Σ | 0..1 | code | home | work | temp | old | billing - purpose of this address Binding: AddressUse (required): The use of an address. Example General: home
type | Σ | 0..1 | code | postal | physical | both Binding: AddressType (required): The type of an address (physical / postal). Example General: both
text | Σ | 0..1 | string | Text representation of the address Example General: 137 Nowhere Street, Erewhon 9132
line | S Σ | 0..4 | string | Street name, number, direction & P.O. Box etc. This repeating element order: The order in which lines should appear in an address label Example General: 137 Nowhere Street Example US Core: 49 MEADOW ST
city | S Σ | 0..1 | string | Name of city, town etc. Example General: Erewhon Example US Core: EVERYTOWN
district | Σ | 0..1 | string | District name (aka county) Example General: Madison
state | S Σ | 0..1 | string | Sub-unit of country (abbreviations ok) Binding: USPS Two Letter Alphabetic Codes (extensible): Two letter USPS alphabetic codes. Example US Core: OK
postalCode | S Σ | 0..1 | string | US Zip Codes Example General: 9132 Example US Core: 74047
country | S Σ | 0..1 | string | Country (e.g. can be ISO 3166 2 or 3 letter code)
period | Σ | 0..1 | Period | Time period when address was/is in use Example General: {"start":"2010-03-23","end":"2010-07-01"}
gender | Σ | 0..1 | code | male | female | other | unknown Binding: AdministrativeGender (required): The gender of a person used for administrative purposes.
birthDate | Σ | 0..1 | date | The date on which the practitioner was born
photo |  | 0..* | Attachment | Image of the person
qualification |  | 0..* | BackboneElement | Certification, licenses, or training pertaining to the provision of care
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
identifier |  | 0..* | Identifier | An identifier for this qualification for the practitioner
code |  | 1..1 | CodeableConcept | Coded representation of the qualification Binding: v2 table 0360, Version 2.7 (example): Specific qualification the practitioner has to provide a service.
period |  | 0..1 | Period | Period during which the qualification is valid
issuer |  | 0..1 | Reference(Organization) | Organization that regulates and issues the qualification
communication |  | 0..* | CodeableConcept | A language the practitioner can use in patient communication Binding: CommonLanguages (preferred): A human language.
Additional Bindings | Purpose
AllLanguages | Max Binding
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
Practitioner.language | Base | preferred | Common Languages | 📍4.0.1 | FHIR Std.
Practitioner.identifier.​use | Base | required | IdentifierUse | 📍4.0.1 | FHIR Std.
Practitioner.identifier.​type | Base | extensible | IdentifierType | 📍4.0.1 | FHIR Std.
Practitioner.identifier:NPI.​use | Base | required | IdentifierUse | 📍4.0.1 | FHIR Std.
Practitioner.identifier:NPI.​type | Base | extensible | IdentifierType | 📍4.0.1 | FHIR Std.
Practitioner.name.use | Base | required | NameUse | 📍4.0.1 | FHIR Std.
Practitioner.telecom.​system | Base | required | ContactPointSystem | 📍4.0.1 | FHIR Std.
Practitioner.telecom.​use | Base | required | ContactPointUse | 📍4.0.1 | FHIR Std.
Practitioner.address.​use | Base | required | AddressUse | 📍4.0.1 | FHIR Std.
Practitioner.address.​type | Base | required | AddressType | 📍4.0.1 | FHIR Std.
Practitioner.address.​state | Base | extensible | USPS Two Letter Alphabetic Codes | 📦1.0.0 | THO v7.1
Practitioner.gender | Base | required | AdministrativeGender | 📍4.0.1 | FHIR Std.
Practitioner.qualification.​code | Base | example | v2 table 0360, Version 2.7 | 📦0360 | FHIR Std.
Practitioner.communication | Base | preferred | Common Languages | 📍4.0.1 | FHIR Std.

#### Constraints

Id | Grade | Path(s) | Description | Expression
dom-2 | error | Practitioner | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | Practitioner | 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 | error | Practitioner | 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 | error | Practitioner | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | Practitioner | A resource should have narrative for robust management | `text.`div`.exists()`
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children | `hasValue() or (children().count() > id.count())`
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`
us-core-16 | error | Practitioner.identifier:NPI | NPI must be 10 digits | `value.matches('^[0-9]{10}$')`
us-core-17 | error | Practitioner.identifier:NPI | NPI check digit must be valid (Luhn algorithm check) | `(((select(value.substring(0,1).toInteger()).select(iif($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)`

This structure is derived from Practitioner

Summary

Mandatory: 3 elements(2 nested mandatory elements)
Must-Support: 15 elements

Slices

This structure defines the following Slices:

- The element 1 is sliced based on the value of Practitioner.identifier

Maturity: 3

Key Elements View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Practitioner |  | 0..* | Practitioner | A person with a formal responsibility in the provisioning of healthcare or related services
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
Slices for identifier | S Σ | 1..* | Identifier | An identifier for the person as this agent Slice: Unordered, Open by value:$this
identifier:All Slices |  |  |  | Content/Rules for all slices
use | ?!Σ | 0..1 | code | usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
system | S Σ | 1..1 | uri | The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
value | S Σ | 1..1 | string | The value that is unique Example General: 123456
identifier:NPI | S Σ C | 0..* | Identifier | An identifier for the person as this agent Constraints: us-core-16, us-core-17 Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
type |  | 0..1 | CodeableConcept | Description of identifier
period |  | 0..1 | Period | Time period when id is/was valid for use
assigner |  | 0..1 | Reference(Organization) | Organization that issued id (may be just text)
use | ?!Σ | 0..1 | code | usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
system | S Σ | 1..1 | uri | The namespace for the identifier value Fixed Value: http://hl7.org/fhir/sid/us-npi
value | S Σ | 1..1 | string | The value that is unique Example General: 123456
name | S Σ | 1..* | HumanName | The name(s) associated with the practitioner
use | ?!Σ | 0..1 | code | usual | official | temp | nickname | anonymous | old | maiden Binding: NameUse (required): The use of a human name.
family | S Σ | 1..1 | string | Family name (often called 'Surname')
telecom | S Σ | 0..* | ContactPoint | A contact detail for the practitioner (that apply to all roles)
system | S Σ C | 0..1 | code | phone | fax | email | pager | url | sms | other Binding: ContactPointSystem (required): Telecommunications form for contact point.
value | S Σ | 0..1 | string | The actual contact point details
use | ?!Σ | 0..1 | code | home | work | temp | old | mobile - purpose of this contact point Binding: ContactPointUse (required): Use of contact point.
address | S Σ | 0..* | Address | Address(es) of the practitioner
use | ?!Σ | 0..1 | code | home | work | temp | old | billing - purpose of this address Binding: AddressUse (required): The use of an address. Example General: home
line | S Σ | 0..4 | string | Street name, number, direction & P.O. Box etc. This repeating element order: The order in which lines should appear in an address label Example General: 137 Nowhere Street Example US Core: 49 MEADOW ST
city | S Σ | 0..1 | string | Name of city, town etc. Example General: Erewhon Example US Core: EVERYTOWN
state | S Σ | 0..1 | string | Sub-unit of country (abbreviations ok) Binding: USPS Two Letter Alphabetic Codes (extensible): Two letter USPS alphabetic codes. Example US Core: OK
postalCode | S Σ | 0..1 | string | US Zip Codes Example General: 9132 Example US Core: 74047
country | S Σ | 0..1 | string | Country (e.g. can be ISO 3166 2 or 3 letter code)
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
Practitioner.identifier.​use | Base | required | IdentifierUse | 📍4.0.1 | FHIR Std.
Practitioner.identifier:NPI.​use | Base | required | IdentifierUse | 📍4.0.1 | FHIR Std.
Practitioner.name.use | Base | required | NameUse | 📍4.0.1 | FHIR Std.
Practitioner.telecom.​system | Base | required | ContactPointSystem | 📍4.0.1 | FHIR Std.
Practitioner.telecom.​use | Base | required | ContactPointUse | 📍4.0.1 | FHIR Std.
Practitioner.address.​use | Base | required | AddressUse | 📍4.0.1 | FHIR Std.
Practitioner.address.​state | Base | extensible | USPS Two Letter Alphabetic Codes | 📦1.0.0 | THO v7.1

#### Constraints

Id | Grade | Path(s) | Description | Expression
dom-2 | error | Practitioner | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | Practitioner | 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 | error | Practitioner | 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 | error | Practitioner | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | Practitioner | A resource should have narrative for robust management | `text.`div`.exists()`
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children | `hasValue() or (children().count() > id.count())`
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`
us-core-16 | error | Practitioner.identifier:NPI | NPI must be 10 digits | `value.matches('^[0-9]{10}$')`
us-core-17 | error | Practitioner.identifier:NPI | NPI check digit must be valid (Luhn algorithm check) | `(((select(value.substring(0,1).toInteger()).select(iif($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)`

Differential View

This structure is derived from Practitioner

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Practitioner |  | 0..* | Practitioner | A person with a formal responsibility in the provisioning of healthcare or related services
Slices for identifier | S | 1..* | Identifier | An identifier for the person as this agent Slice: Unordered, Open by value:$this
identifier:All Slices |  |  |  | Content/Rules for all slices
system | S | 1..1 | uri | The namespace for the identifier value
value | S | 1..1 | string | The value that is unique
identifier:NPI | S C | 0..* | Identifier | An identifier for the person as this agent Constraints: us-core-16, us-core-17 Required Pattern: At least the following
system |  | 1..1 | uri | The namespace for the identifier value Fixed Value: http://hl7.org/fhir/sid/us-npi
name | S | 1..* | HumanName | The name(s) associated with the practitioner
family | S | 1..1 | string | Family name (often called 'Surname')
telecom | S | 0..* | ContactPoint | A contact detail for the practitioner (that apply to all roles)
system | S | 0..1 | code | phone | fax | email | pager | url | sms | other
value | S | 0..1 | string | The actual contact point details
address | S | 0..* | Address | Address(es) of the practitioner
line | S | 0..4 | string | Street name, number, direction & P.O. Box etc. Example US Core: 49 MEADOW ST
city | S | 0..1 | string | Name of city, town etc. Example US Core: EVERYTOWN
state | S | 0..1 | string | Sub-unit of country (abbreviations ok) Binding: USPS Two Letter Alphabetic Codes (extensible): Two letter USPS alphabetic codes. Example US Core: OK
postalCode | S | 0..1 | string | US Zip Codes Example US Core: 74047
country | S | 0..1 | string | Country (e.g. can be ISO 3166 2 or 3 letter code)
Documentation for this format

#### Terminology Bindings (Differential)

Path | Status | Usage | ValueSet | Version | Source
Practitioner.address.​state | Base | extensible | USPS Two Letter Alphabetic Codes | 📦1.0.0 | THO v7.1

#### Constraints

Id | Grade | Path(s) | Description | Expression
us-core-16 | error | Practitioner.identifier:NPI | NPI must be 10 digits | `value.matches('^[0-9]{10}$')`
us-core-17 | error | Practitioner.identifier:NPI | NPI check digit must be valid (Luhn algorithm check) | `(((select(value.substring(0,1).toInteger()).select(iif($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)`

Snapshot View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Practitioner |  | 0..* | Practitioner | A person with a formal responsibility in the provisioning of healthcare or related services
id | Σ | 0..1 | id | Logical id of this artifact
meta | Σ | 0..1 | Meta | Metadata about the resource
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
language |  | 0..1 | code | Language of the resource content Binding: CommonLanguages (preferred): A human language.
Additional Bindings | Purpose
AllLanguages | Max Binding
text |  | 0..1 | Narrative | Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained |  | 0..* | Resource | Contained, inline Resources
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
Slices for identifier | S Σ | 1..* | Identifier | An identifier for the person as this agent Slice: Unordered, Open by value:$this
identifier:All Slices |  |  |  | Content/Rules for all slices
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
use | ?!Σ | 0..1 | code | usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type | Σ | 0..1 | CodeableConcept | Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
system | S Σ | 1..1 | uri | The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
value | S Σ | 1..1 | string | The value that is unique Example General: 123456
period | Σ | 0..1 | Period | Time period when id is/was valid for use
assigner | Σ | 0..1 | Reference(Organization) | Organization that issued id (may be just text)
identifier:NPI | S Σ C | 0..* | Identifier | An identifier for the person as this agent Constraints: us-core-16, us-core-17 Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
use | ?!Σ | 0..1 | code | usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type | Σ | 0..1 | CodeableConcept | Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
system | S Σ | 1..1 | uri | The namespace for the identifier value Fixed Value: http://hl7.org/fhir/sid/us-npi
value | S Σ | 1..1 | string | The value that is unique Example General: 123456
period | Σ | 0..1 | Period | Time period when id is/was valid for use
assigner | Σ | 0..1 | Reference(Organization) | Organization that issued id (may be just text)
active | Σ | 0..1 | boolean | Whether this practitioner's record is in active use
name | S Σ | 1..* | HumanName | The name(s) associated with the practitioner
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
use | ?!Σ | 0..1 | code | usual | official | temp | nickname | anonymous | old | maiden Binding: NameUse (required): The use of a human name.
text | Σ | 0..1 | string | Text representation of the full name
family | S Σ | 1..1 | string | Family name (often called 'Surname')
given | Σ | 0..* | string | Given names (not always 'first'). Includes middle names This repeating element order: Given Names appear in the correct order for presenting the name
prefix | Σ | 0..* | string | Parts that come before the name This repeating element order: Prefixes appear in the correct order for presenting the name
suffix | Σ | 0..* | string | Parts that come after the name This repeating element order: Suffixes appear in the correct order for presenting the name
period | Σ | 0..1 | Period | Time period when name was/is in use
telecom | S Σ | 0..* | ContactPoint | A contact detail for the practitioner (that apply to all roles)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
system | S Σ C | 0..1 | code | phone | fax | email | pager | url | sms | other Binding: ContactPointSystem (required): Telecommunications form for contact point.
value | S Σ | 0..1 | string | The actual contact point details
use | ?!Σ | 0..1 | code | home | work | temp | old | mobile - purpose of this contact point Binding: ContactPointUse (required): Use of contact point.
rank | Σ | 0..1 | positiveInt | Specify preferred order of use (1 = highest)
period | Σ | 0..1 | Period | Time period when the contact point was/is in use
address | S Σ | 0..* | Address | Address(es) of the practitioner
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
use | ?!Σ | 0..1 | code | home | work | temp | old | billing - purpose of this address Binding: AddressUse (required): The use of an address. Example General: home
type | Σ | 0..1 | code | postal | physical | both Binding: AddressType (required): The type of an address (physical / postal). Example General: both
text | Σ | 0..1 | string | Text representation of the address Example General: 137 Nowhere Street, Erewhon 9132
line | S Σ | 0..4 | string | Street name, number, direction & P.O. Box etc. This repeating element order: The order in which lines should appear in an address label Example General: 137 Nowhere Street Example US Core: 49 MEADOW ST
city | S Σ | 0..1 | string | Name of city, town etc. Example General: Erewhon Example US Core: EVERYTOWN
district | Σ | 0..1 | string | District name (aka county) Example General: Madison
state | S Σ | 0..1 | string | Sub-unit of country (abbreviations ok) Binding: USPS Two Letter Alphabetic Codes (extensible): Two letter USPS alphabetic codes. Example US Core: OK
postalCode | S Σ | 0..1 | string | US Zip Codes Example General: 9132 Example US Core: 74047
country | S Σ | 0..1 | string | Country (e.g. can be ISO 3166 2 or 3 letter code)
period | Σ | 0..1 | Period | Time period when address was/is in use Example General: {"start":"2010-03-23","end":"2010-07-01"}
gender | Σ | 0..1 | code | male | female | other | unknown Binding: AdministrativeGender (required): The gender of a person used for administrative purposes.
birthDate | Σ | 0..1 | date | The date on which the practitioner was born
photo |  | 0..* | Attachment | Image of the person
qualification |  | 0..* | BackboneElement | Certification, licenses, or training pertaining to the provision of care
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
identifier |  | 0..* | Identifier | An identifier for this qualification for the practitioner
code |  | 1..1 | CodeableConcept | Coded representation of the qualification Binding: v2 table 0360, Version 2.7 (example): Specific qualification the practitioner has to provide a service.
period |  | 0..1 | Period | Period during which the qualification is valid
issuer |  | 0..1 | Reference(Organization) | Organization that regulates and issues the qualification
communication |  | 0..* | CodeableConcept | A language the practitioner can use in patient communication Binding: CommonLanguages (preferred): A human language.
Additional Bindings | Purpose
AllLanguages | Max Binding
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
Practitioner.language | Base | preferred | Common Languages | 📍4.0.1 | FHIR Std.
Practitioner.identifier.​use | Base | required | IdentifierUse | 📍4.0.1 | FHIR Std.
Practitioner.identifier.​type | Base | extensible | IdentifierType | 📍4.0.1 | FHIR Std.
Practitioner.identifier:NPI.​use | Base | required | IdentifierUse | 📍4.0.1 | FHIR Std.
Practitioner.identifier:NPI.​type | Base | extensible | IdentifierType | 📍4.0.1 | FHIR Std.
Practitioner.name.use | Base | required | NameUse | 📍4.0.1 | FHIR Std.
Practitioner.telecom.​system | Base | required | ContactPointSystem | 📍4.0.1 | FHIR Std.
Practitioner.telecom.​use | Base | required | ContactPointUse | 📍4.0.1 | FHIR Std.
Practitioner.address.​use | Base | required | AddressUse | 📍4.0.1 | FHIR Std.
Practitioner.address.​type | Base | required | AddressType | 📍4.0.1 | FHIR Std.
Practitioner.address.​state | Base | extensible | USPS Two Letter Alphabetic Codes | 📦1.0.0 | THO v7.1
Practitioner.gender | Base | required | AdministrativeGender | 📍4.0.1 | FHIR Std.
Practitioner.qualification.​code | Base | example | v2 table 0360, Version 2.7 | 📦0360 | FHIR Std.
Practitioner.communication | Base | preferred | Common Languages | 📍4.0.1 | FHIR Std.

#### Constraints

Id | Grade | Path(s) | Description | Expression
dom-2 | error | Practitioner | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | Practitioner | 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 | error | Practitioner | 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 | error | Practitioner | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | Practitioner | A resource should have narrative for robust management | `text.`div`.exists()`
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children | `hasValue() or (children().count() > id.count())`
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`
us-core-16 | error | Practitioner.identifier:NPI | NPI must be 10 digits | `value.matches('^[0-9]{10}$')`
us-core-17 | error | Practitioner.identifier:NPI | NPI check digit must be valid (Luhn algorithm check) | `(((select(value.substring(0,1).toInteger()).select(iif($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)`

This structure is derived from Practitioner

Summary

Mandatory: 3 elements(2 nested mandatory elements)
Must-Support: 15 elements

Slices

This structure defines the following Slices:

- The element 1 is sliced based on the value of Practitioner.identifier

Maturity: 3

Other representations of profile: CSV, Excel, Schematron

### Notes:

Quick Start

Below is an overview of the required Server RESTful FHIR interactions for this profile - for example, search and read operations - when supporting the US Core interactions to access this profile's information (Profile Support + Interaction Support). Note that systems that support only US Core Profiles (Profile Only Support) are not required to support these interactions. See the US Core Server CapabilityStatement for a complete list of supported RESTful interactions for this IG.

- See the Scopes Format section for a description of the SMART scopes syntax.
- See the Search Syntax section for a description of the US Core search syntax.
- See the General Requirements section for additional rules and expectations when a Server requires status parameters.
- See the General Guidance section for additional guidance on searching for multiple patients.

#### US Core Scopes

Servers providing access to practitioner data SHALL support these US Core SMART Scopes:

- resource level scopes: `<patient|user|system>/Practitioner.rs`

#### Mandatory Search Parameters:

The following search parameters and search parameter combinations SHALL be supported:

1. SHALL support searching for a practitioner by a string match of any part of name using the `name` search parameter:

   `GET [base]/Practitioner?name=[string]`

   Example:

   1. GET [base]/Practitioner?name=Smith

   Implementation Notes: Fetches a bundle of all Practitioner resources matching the name (how to search by string)

2. SHALL support searching a practitioner by an identifier such as an NPI using the `identifier` search parameter:

   `GET [base]/Practitioner?identifier={system|}[code]`

   Example:

   1. GET [base]/Practitioner?dentifier=http://hl7.org/fhir/sid/us-npi|97860456

   Implementation Notes: Fetches a bundle containing any Practitioner resources matching the identifier (how to search by token)

#### Optional Search Parameters:

The following search parameter combinations SHOULD be supported:

1. SHOULD support both read Practitioner by `id` AND Practitioner search using the `_id` search parameter:

   `GET [base]/Practitioner/[id]` or `GET [base]/Practitioner?_id=[id]`

   Example:

   1. GET [base]/Practitioner/practitioner-1
   2. GET [base]/Practitioner?_id=practitioner-1

   Implementation Notes: (how to search by the logical id of the resource)