Patient Cost Transparency Implementation Guide, published by HL7 International / Financial Management. This guide is not an authorized publication; it is the continuous build for version 2.0.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/davinci-pct/ and changes regularly. See the Directory of published versions

• Content
• Detailed Descriptions
• Mappings
• Examples
• XML
• JSON
• TTL

Resource Profile: PCT Practitioner

The PCT Practitioner profile builds upon the US Core Practitioner profile. It is used to convey information about the practitioner who will be providing services to the patient as described on the GFE.

Usages:

• Use this Profile: PCT AEOB Packet, PCT GFE Bundle, PCT GFE Information Bundle, PCT GFE Missing Bundle and PCT GFE Packet
• Refer to this Profile: PCT AEOB Composition, PCT AEOB Packet Document Reference, PCT Advanced EOB, PCT GFE Composition... Show 6 more, PCT GFE Contributor Task, PCT GFE Coordination Task, PCT GFE Packet Document Reference, PCT Good Faith Estimate Institutional, PCT Good Faith Estimate Professional and PCT Good Faith Estimate Summary
• Examples for this Profile: Practitioner/Submitter-Practitioner-1, Practitioner/prac001 and Practitioner/prac002
• CapabilityStatements using this Profile: Patient Cost Transparency Implementation Guide Coordination Platform Capability Statement, Patient Cost Transparency Implementation Guide Coordination Requester Capability Statement and Patient Cost Transparency Implementation Guide Payer Capability Statement

You can also check for usages in the FHIR IG Statistics

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..*	USCorePractitionerProfile(7.0.0)	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	SΣ	1..*	Identifier	An identifier for the person as this agent Slice: Unordered, Open by pattern:$this
identifier:NPI	SΣC	0..1	Identifier	The National Provider Identifier assigned to the provider. 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
use		0..1	code	usual | official | temp | secondary | old (If known)
type		0..1	CodeableConcept	Description of identifier
system		1..1	uri	The namespace for the identifier value Fixed Value: http://hl7.org/fhir/sid/us-npi
value		0..1	string	The value that is unique
period		0..1	Period	Time period when id is/was valid for use
assigner		0..1	Reference(Organization)	Organization that issued id (may be just text)
identifier:ETIN	SΣ	0..1	Identifier	The submitter's Electronic Transmitter Identification Number. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
use		0..1	code	usual | official | temp | secondary | old (If known)
type		1..1	CodeableConcept	Description of identifier Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/v2-0203
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: ETIN
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
system		0..1	uri	The namespace for the identifier value
value		0..1	string	The value that is unique
period		0..1	Period	Time period when id is/was valid for use
assigner		0..1	Reference(Organization)	Organization that issued id (may be just text)
identifier:tin	SΣ	0..1	Identifier	Tax ID Number Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
use		0..1	code	usual | official | temp | secondary | old (If known)
type		1..1	CodeableConcept	Description of identifier Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/v2-0203
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: TAX
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
system		0..1	uri	The namespace for the identifier value
value		0..1	string	The value that is unique
period		0..1	Period	Time period when id is/was valid for use
assigner		0..1	Reference(Organization)	Organization that issued id (may be just text)
name	SΣ	1..*	HumanName	The name(s) associated with the practitioner
use	?!Σ	0..1	code	usual | official | temp | nickname | anonymous | old | maiden Binding: NameUse (required): The use of a human name.
family	SΣ	1..1	string	Family name (often called 'Surname')
given	Σ	1..1	string	Given names (not always 'first'). Includes middle names This repeating element order: Given Names appear in the correct order for presenting the name
telecom	SΣ	0..*	ContactPoint	A contact detail for the practitioner (that apply to all roles)
system	SΣC	0..1	code	phone | fax | email | pager | url | sms | other Binding: ContactPointSystem (required): Telecommunications form for contact point.
value	SΣ	0..1	string	The actual contact point details
use	?!Σ	0..1	code	home | work | temp | old | mobile - purpose of this contact point Binding: ContactPointUse (required): Use of contact point.
address	SΣ	0..*	Address	Address(es) of the practitioner
use	?!Σ	0..1	code	home | work | temp | old | billing - purpose of this address Binding: AddressUse (required): The use of an address. Example General: home
line	SΣ	0..4	string	Street name, number, direction & P.O. Box etc. This repeating element order: The order in which lines should appear in an address label Example General: 137 Nowhere Street Example General: 49 MEADOW ST
city	SΣ	0..1	string	Name of city, town etc. Example General: Erewhon Example General: EVERYTOWN
state	SΣ	0..1	string	Sub-unit of country (abbreviations ok) Binding: UspsTwoLetterAlphabeticCodes (7.0.0) (extensible): Two letter USPS alphabetic codes. Example General: OK
postalCode	SΣ	0..1	string	US Zip Codes Example General: 9132 Example General: 74047
country	SΣ	0..1	string	Country (e.g. can be ISO 3166 2 or 3 letter code)
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
Practitioner.name.use	required	NameUse http://hl7.org/fhir/ValueSet/name-use|4.0.1 From the FHIR Standard
Practitioner.telecom.system	required	ContactPointSystem http://hl7.org/fhir/ValueSet/contact-point-system|4.0.1 From the FHIR Standard
Practitioner.telecom.use	required	ContactPointUse http://hl7.org/fhir/ValueSet/contact-point-use|4.0.1 From the FHIR Standard
Practitioner.address.use	required	AddressUse http://hl7.org/fhir/ValueSet/address-use|4.0.1 From the FHIR Standard
Practitioner.address.state	extensible	UspsTwoLetterAlphabeticCodes http://hl7.org/fhir/us/core/ValueSet/us-core-usps-state|7.0.0

Constraints

Id	Grade	Path(s)	Details	Requirements
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 USCorePractitionerProfile

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Practitioner			USCorePractitionerProfile(7.0.0)
Slices for identifier				Content/Rules for all slices
identifier:NPI		0..1	Identifier	The National Provider Identifier assigned to the provider.
identifier:ETIN	S	0..1	Identifier	The submitter's Electronic Transmitter Identification Number. Required Pattern: At least the following
type		1..1	CodeableConcept	Description of identifier Fixed Value: (Complex)
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/v2-0203
code		1..1	code	Symbol in syntax defined by the system Fixed Value: ETIN
identifier:tin	S	0..1	Identifier	Tax ID Number Required Pattern: At least the following
type		1..1	CodeableConcept	Description of identifier Fixed Value: (Complex)
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/v2-0203
code		1..1	code	Symbol in syntax defined by the system Fixed Value: TAX
name
given		1..1	string	Given names (not always 'first'). Includes middle names
qualification
code		1..1	CodeableConcept	Coded representation of the qualification Binding: NUCCProviderCodes (3.0.0) (required)
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet	URI
Practitioner.qualification.code	required	NUCCProviderCodes(a valid code from http://nucc.org/provider-taxonomy) http://terminology.hl7.org/ValueSet/v3-NUCCProviderCodes|3.0.0

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Practitioner		0..*	USCorePractitionerProfile(7.0.0)	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	SΣ	1..*	Identifier	An identifier for the person as this agent Slice: Unordered, Open by pattern:$this
identifier:NPI	SΣC	0..1	Identifier	The National Provider Identifier assigned to the provider. 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
use		0..1	code	usual | official | temp | secondary | old (If known)
type		0..1	CodeableConcept	Description of identifier
system		1..1	uri	The namespace for the identifier value Fixed Value: http://hl7.org/fhir/sid/us-npi
value		0..1	string	The value that is unique
period		0..1	Period	Time period when id is/was valid for use
assigner		0..1	Reference(Organization)	Organization that issued id (may be just text)
identifier:ETIN	SΣ	0..1	Identifier	The submitter's Electronic Transmitter Identification Number. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
use		0..1	code	usual | official | temp | secondary | old (If known)
type		1..1	CodeableConcept	Description of identifier Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/v2-0203
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: ETIN
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
system		0..1	uri	The namespace for the identifier value
value		0..1	string	The value that is unique
period		0..1	Period	Time period when id is/was valid for use
assigner		0..1	Reference(Organization)	Organization that issued id (may be just text)
identifier:tin	SΣ	0..1	Identifier	Tax ID Number Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
use		0..1	code	usual | official | temp | secondary | old (If known)
type		1..1	CodeableConcept	Description of identifier Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/v2-0203
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: TAX
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
system		0..1	uri	The namespace for the identifier value
value		0..1	string	The value that is unique
period		0..1	Period	Time period when id is/was valid for use
assigner		0..1	Reference(Organization)	Organization that issued id (may be just text)
active	Σ	0..1	boolean	Whether this practitioner's record is in active use
name	SΣ	1..*	HumanName	The name(s) associated with the practitioner
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
use	?!Σ	0..1	code	usual | official | temp | nickname | anonymous | old | maiden Binding: NameUse (required): The use of a human name.
text	Σ	0..1	string	Text representation of the full name
family	SΣ	1..1	string	Family name (often called 'Surname')
given	Σ	1..1	string	Given names (not always 'first'). Includes middle names This repeating element order: Given Names appear in the correct order for presenting the name
prefix	Σ	0..*	string	Parts that come before the name This repeating element order: Prefixes appear in the correct order for presenting the name
suffix	Σ	0..*	string	Parts that come after the name This repeating element order: Suffixes appear in the correct order for presenting the name
period	Σ	0..1	Period	Time period when name was/is in use
telecom	SΣ	0..*	ContactPoint	A contact detail for the practitioner (that apply to all roles)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
system	SΣC	0..1	code	phone | fax | email | pager | url | sms | other Binding: ContactPointSystem (required): Telecommunications form for contact point.
value	SΣ	0..1	string	The actual contact point details
use	?!Σ	0..1	code	home | work | temp | old | mobile - purpose of this contact point Binding: ContactPointUse (required): Use of contact point.
rank	Σ	0..1	positiveInt	Specify preferred order of use (1 = highest)
period	Σ	0..1	Period	Time period when the contact point was/is in use
address	SΣ	0..*	Address	Address(es) of the practitioner
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
use	?!Σ	0..1	code	home | work | temp | old | billing - purpose of this address Binding: AddressUse (required): The use of an address. Example General: home
type	Σ	0..1	code	postal | physical | both Binding: AddressType (required): The type of an address (physical / postal). Example General: both
text	Σ	0..1	string	Text representation of the address Example General: 137 Nowhere Street, Erewhon 9132
line	SΣ	0..4	string	Street name, number, direction & P.O. Box etc. This repeating element order: The order in which lines should appear in an address label Example General: 137 Nowhere Street Example General: 49 MEADOW ST
city	SΣ	0..1	string	Name of city, town etc. Example General: Erewhon Example General: EVERYTOWN
district	Σ	0..1	string	District name (aka county) Example General: Madison
state	SΣ	0..1	string	Sub-unit of country (abbreviations ok) Binding: UspsTwoLetterAlphabeticCodes (7.0.0) (extensible): Two letter USPS alphabetic codes. Example General: OK
postalCode	SΣ	0..1	string	US Zip Codes Example General: 9132 Example General: 74047
country	SΣ	0..1	string	Country (e.g. can be ISO 3166 2 or 3 letter code)
period	Σ	0..1	Period	Time period when address was/is in use Example General: {"start":"2010-03-23","end":"2010-07-01"}
gender	Σ	0..1	code	male | female | other | unknown Binding: AdministrativeGender (required): The gender of a person used for administrative purposes.
birthDate	Σ	0..1	date	The date on which the practitioner was born
photo		0..*	Attachment	Image of the person
qualification		0..*	BackboneElement	Certification, licenses, or training pertaining to the provision of care
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
identifier		0..*	Identifier	An identifier for this qualification for the practitioner
code		1..1	CodeableConcept	Coded representation of the qualification Binding: NUCCProviderCodes (3.0.0) (required)
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	Conformance	ValueSet	URI
Practitioner.language	preferred	CommonLanguages http://hl7.org/fhir/ValueSet/languages From the FHIR Standard Additional Bindings Purpose AllLanguages Max Binding
Practitioner.name.use	required	NameUse http://hl7.org/fhir/ValueSet/name-use|4.0.1 From the FHIR Standard
Practitioner.telecom.system	required	ContactPointSystem http://hl7.org/fhir/ValueSet/contact-point-system|4.0.1 From the FHIR Standard
Practitioner.telecom.use	required	ContactPointUse http://hl7.org/fhir/ValueSet/contact-point-use|4.0.1 From the FHIR Standard
Practitioner.address.use	required	AddressUse http://hl7.org/fhir/ValueSet/address-use|4.0.1 From the FHIR Standard
Practitioner.address.type	required	AddressType http://hl7.org/fhir/ValueSet/address-type|4.0.1 From the FHIR Standard
Practitioner.address.state	extensible	UspsTwoLetterAlphabeticCodes http://hl7.org/fhir/us/core/ValueSet/us-core-usps-state|7.0.0
Practitioner.gender	required	AdministrativeGender http://hl7.org/fhir/ValueSet/administrative-gender|4.0.1 From the FHIR Standard
Practitioner.qualification.code	required	NUCCProviderCodes(a valid code from http://nucc.org/provider-taxonomy) http://terminology.hl7.org/ValueSet/v3-NUCCProviderCodes|3.0.0
Practitioner.communication	preferred	CommonLanguages http://hl7.org/fhir/ValueSet/languages From the FHIR Standard Additional Bindings Purpose AllLanguages Max Binding

Constraints

Id	Grade	Path(s)	Details	Requirements
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 USCorePractitionerProfile

Summary

Mandatory: 1 element
Must-Support: 2 elements

Maturity: 2

Key Elements View

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Practitioner		0..*	USCorePractitionerProfile(7.0.0)	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	SΣ	1..*	Identifier	An identifier for the person as this agent Slice: Unordered, Open by pattern:$this
identifier:NPI	SΣC	0..1	Identifier	The National Provider Identifier assigned to the provider. 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
use		0..1	code	usual | official | temp | secondary | old (If known)
type		0..1	CodeableConcept	Description of identifier
system		1..1	uri	The namespace for the identifier value Fixed Value: http://hl7.org/fhir/sid/us-npi
value		0..1	string	The value that is unique
period		0..1	Period	Time period when id is/was valid for use
assigner		0..1	Reference(Organization)	Organization that issued id (may be just text)
identifier:ETIN	SΣ	0..1	Identifier	The submitter's Electronic Transmitter Identification Number. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
use		0..1	code	usual | official | temp | secondary | old (If known)
type		1..1	CodeableConcept	Description of identifier Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/v2-0203
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: ETIN
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
system		0..1	uri	The namespace for the identifier value
value		0..1	string	The value that is unique
period		0..1	Period	Time period when id is/was valid for use
assigner		0..1	Reference(Organization)	Organization that issued id (may be just text)
identifier:tin	SΣ	0..1	Identifier	Tax ID Number Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
use		0..1	code	usual | official | temp | secondary | old (If known)
type		1..1	CodeableConcept	Description of identifier Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/v2-0203
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: TAX
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
system		0..1	uri	The namespace for the identifier value
value		0..1	string	The value that is unique
period		0..1	Period	Time period when id is/was valid for use
assigner		0..1	Reference(Organization)	Organization that issued id (may be just text)
name	SΣ	1..*	HumanName	The name(s) associated with the practitioner
use	?!Σ	0..1	code	usual | official | temp | nickname | anonymous | old | maiden Binding: NameUse (required): The use of a human name.
family	SΣ	1..1	string	Family name (often called 'Surname')
given	Σ	1..1	string	Given names (not always 'first'). Includes middle names This repeating element order: Given Names appear in the correct order for presenting the name
telecom	SΣ	0..*	ContactPoint	A contact detail for the practitioner (that apply to all roles)
system	SΣC	0..1	code	phone | fax | email | pager | url | sms | other Binding: ContactPointSystem (required): Telecommunications form for contact point.
value	SΣ	0..1	string	The actual contact point details
use	?!Σ	0..1	code	home | work | temp | old | mobile - purpose of this contact point Binding: ContactPointUse (required): Use of contact point.
address	SΣ	0..*	Address	Address(es) of the practitioner
use	?!Σ	0..1	code	home | work | temp | old | billing - purpose of this address Binding: AddressUse (required): The use of an address. Example General: home
line	SΣ	0..4	string	Street name, number, direction & P.O. Box etc. This repeating element order: The order in which lines should appear in an address label Example General: 137 Nowhere Street Example General: 49 MEADOW ST
city	SΣ	0..1	string	Name of city, town etc. Example General: Erewhon Example General: EVERYTOWN
state	SΣ	0..1	string	Sub-unit of country (abbreviations ok) Binding: UspsTwoLetterAlphabeticCodes (7.0.0) (extensible): Two letter USPS alphabetic codes. Example General: OK
postalCode	SΣ	0..1	string	US Zip Codes Example General: 9132 Example General: 74047
country	SΣ	0..1	string	Country (e.g. can be ISO 3166 2 or 3 letter code)
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
Practitioner.name.use	required	NameUse http://hl7.org/fhir/ValueSet/name-use|4.0.1 From the FHIR Standard
Practitioner.telecom.system	required	ContactPointSystem http://hl7.org/fhir/ValueSet/contact-point-system|4.0.1 From the FHIR Standard
Practitioner.telecom.use	required	ContactPointUse http://hl7.org/fhir/ValueSet/contact-point-use|4.0.1 From the FHIR Standard
Practitioner.address.use	required	AddressUse http://hl7.org/fhir/ValueSet/address-use|4.0.1 From the FHIR Standard
Practitioner.address.state	extensible	UspsTwoLetterAlphabeticCodes http://hl7.org/fhir/us/core/ValueSet/us-core-usps-state|7.0.0

Constraints

Id	Grade	Path(s)	Details	Requirements
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 USCorePractitionerProfile

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Practitioner			USCorePractitionerProfile(7.0.0)
Slices for identifier				Content/Rules for all slices
identifier:NPI		0..1	Identifier	The National Provider Identifier assigned to the provider.
identifier:ETIN	S	0..1	Identifier	The submitter's Electronic Transmitter Identification Number. Required Pattern: At least the following
type		1..1	CodeableConcept	Description of identifier Fixed Value: (Complex)
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/v2-0203
code		1..1	code	Symbol in syntax defined by the system Fixed Value: ETIN
identifier:tin	S	0..1	Identifier	Tax ID Number Required Pattern: At least the following
type		1..1	CodeableConcept	Description of identifier Fixed Value: (Complex)
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/v2-0203
code		1..1	code	Symbol in syntax defined by the system Fixed Value: TAX
name
given		1..1	string	Given names (not always 'first'). Includes middle names
qualification
code		1..1	CodeableConcept	Coded representation of the qualification Binding: NUCCProviderCodes (3.0.0) (required)
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet	URI
Practitioner.qualification.code	required	NUCCProviderCodes(a valid code from http://nucc.org/provider-taxonomy) http://terminology.hl7.org/ValueSet/v3-NUCCProviderCodes|3.0.0

Snapshot View

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Practitioner		0..*	USCorePractitionerProfile(7.0.0)	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	SΣ	1..*	Identifier	An identifier for the person as this agent Slice: Unordered, Open by pattern:$this
identifier:NPI	SΣC	0..1	Identifier	The National Provider Identifier assigned to the provider. 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
use		0..1	code	usual | official | temp | secondary | old (If known)
type		0..1	CodeableConcept	Description of identifier
system		1..1	uri	The namespace for the identifier value Fixed Value: http://hl7.org/fhir/sid/us-npi
value		0..1	string	The value that is unique
period		0..1	Period	Time period when id is/was valid for use
assigner		0..1	Reference(Organization)	Organization that issued id (may be just text)
identifier:ETIN	SΣ	0..1	Identifier	The submitter's Electronic Transmitter Identification Number. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
use		0..1	code	usual | official | temp | secondary | old (If known)
type		1..1	CodeableConcept	Description of identifier Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/v2-0203
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: ETIN
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
system		0..1	uri	The namespace for the identifier value
value		0..1	string	The value that is unique
period		0..1	Period	Time period when id is/was valid for use
assigner		0..1	Reference(Organization)	Organization that issued id (may be just text)
identifier:tin	SΣ	0..1	Identifier	Tax ID Number Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
use		0..1	code	usual | official | temp | secondary | old (If known)
type		1..1	CodeableConcept	Description of identifier Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/v2-0203
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: TAX
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
system		0..1	uri	The namespace for the identifier value
value		0..1	string	The value that is unique
period		0..1	Period	Time period when id is/was valid for use
assigner		0..1	Reference(Organization)	Organization that issued id (may be just text)
active	Σ	0..1	boolean	Whether this practitioner's record is in active use
name	SΣ	1..*	HumanName	The name(s) associated with the practitioner
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
use	?!Σ	0..1	code	usual | official | temp | nickname | anonymous | old | maiden Binding: NameUse (required): The use of a human name.
text	Σ	0..1	string	Text representation of the full name
family	SΣ	1..1	string	Family name (often called 'Surname')
given	Σ	1..1	string	Given names (not always 'first'). Includes middle names This repeating element order: Given Names appear in the correct order for presenting the name
prefix	Σ	0..*	string	Parts that come before the name This repeating element order: Prefixes appear in the correct order for presenting the name
suffix	Σ	0..*	string	Parts that come after the name This repeating element order: Suffixes appear in the correct order for presenting the name
period	Σ	0..1	Period	Time period when name was/is in use
telecom	SΣ	0..*	ContactPoint	A contact detail for the practitioner (that apply to all roles)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
system	SΣC	0..1	code	phone | fax | email | pager | url | sms | other Binding: ContactPointSystem (required): Telecommunications form for contact point.
value	SΣ	0..1	string	The actual contact point details
use	?!Σ	0..1	code	home | work | temp | old | mobile - purpose of this contact point Binding: ContactPointUse (required): Use of contact point.
rank	Σ	0..1	positiveInt	Specify preferred order of use (1 = highest)
period	Σ	0..1	Period	Time period when the contact point was/is in use
address	SΣ	0..*	Address	Address(es) of the practitioner
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
use	?!Σ	0..1	code	home | work | temp | old | billing - purpose of this address Binding: AddressUse (required): The use of an address. Example General: home
type	Σ	0..1	code	postal | physical | both Binding: AddressType (required): The type of an address (physical / postal). Example General: both
text	Σ	0..1	string	Text representation of the address Example General: 137 Nowhere Street, Erewhon 9132
line	SΣ	0..4	string	Street name, number, direction & P.O. Box etc. This repeating element order: The order in which lines should appear in an address label Example General: 137 Nowhere Street Example General: 49 MEADOW ST
city	SΣ	0..1	string	Name of city, town etc. Example General: Erewhon Example General: EVERYTOWN
district	Σ	0..1	string	District name (aka county) Example General: Madison
state	SΣ	0..1	string	Sub-unit of country (abbreviations ok) Binding: UspsTwoLetterAlphabeticCodes (7.0.0) (extensible): Two letter USPS alphabetic codes. Example General: OK
postalCode	SΣ	0..1	string	US Zip Codes Example General: 9132 Example General: 74047
country	SΣ	0..1	string	Country (e.g. can be ISO 3166 2 or 3 letter code)
period	Σ	0..1	Period	Time period when address was/is in use Example General: {"start":"2010-03-23","end":"2010-07-01"}
gender	Σ	0..1	code	male | female | other | unknown Binding: AdministrativeGender (required): The gender of a person used for administrative purposes.
birthDate	Σ	0..1	date	The date on which the practitioner was born
photo		0..*	Attachment	Image of the person
qualification		0..*	BackboneElement	Certification, licenses, or training pertaining to the provision of care
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
identifier		0..*	Identifier	An identifier for this qualification for the practitioner
code		1..1	CodeableConcept	Coded representation of the qualification Binding: NUCCProviderCodes (3.0.0) (required)
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	Conformance	ValueSet	URI
Practitioner.language	preferred	CommonLanguages http://hl7.org/fhir/ValueSet/languages From the FHIR Standard Additional Bindings Purpose AllLanguages Max Binding
Practitioner.name.use	required	NameUse http://hl7.org/fhir/ValueSet/name-use|4.0.1 From the FHIR Standard
Practitioner.telecom.system	required	ContactPointSystem http://hl7.org/fhir/ValueSet/contact-point-system|4.0.1 From the FHIR Standard
Practitioner.telecom.use	required	ContactPointUse http://hl7.org/fhir/ValueSet/contact-point-use|4.0.1 From the FHIR Standard
Practitioner.address.use	required	AddressUse http://hl7.org/fhir/ValueSet/address-use|4.0.1 From the FHIR Standard
Practitioner.address.type	required	AddressType http://hl7.org/fhir/ValueSet/address-type|4.0.1 From the FHIR Standard
Practitioner.address.state	extensible	UspsTwoLetterAlphabeticCodes http://hl7.org/fhir/us/core/ValueSet/us-core-usps-state|7.0.0
Practitioner.gender	required	AdministrativeGender http://hl7.org/fhir/ValueSet/administrative-gender|4.0.1 From the FHIR Standard
Practitioner.qualification.code	required	NUCCProviderCodes(a valid code from http://nucc.org/provider-taxonomy) http://terminology.hl7.org/ValueSet/v3-NUCCProviderCodes|3.0.0
Practitioner.communication	preferred	CommonLanguages http://hl7.org/fhir/ValueSet/languages From the FHIR Standard Additional Bindings Purpose AllLanguages Max Binding

Constraints

Id	Grade	Path(s)	Details	Requirements
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 USCorePractitionerProfile

Summary

Mandatory: 1 element
Must-Support: 2 elements

Maturity: 2

Other representations of profile: CSV, Excel, Schematron