The Practitioner (Type 1) domain represents an individual healthcare provider involved in the delivery of care, such as physicians, nurses, and other licensed clinicians. This domain models a Provider as a person acting in a professional healthcare role, capturing identifiers, credentials, specialties, licensure, availability, and participation in care delivery and administrative workflows.
- Use the Practitioner domain when:
- You are modeling an individual clinician or care provider.
- National Provider Identifiers (NPIs), licenses, or specialties are required.
- You need to support provider directory, referral, credentialing, or network participation use cases.
- Provider availability, accepted insurances, or roles are relevant.
- Do not use this domain when:
- Modeling organizations or locations (use Health Facility instead).
- Only non‑clinical organizational identity is required.
- Entity: Provider
- Type: Type 1 (Individual Provider)
- Scope: The Practitioner domain represents a single real‑world individual provider. It does not represent organizations or care locations.
The Practitioner schema is composed of professional, demographic, and administrative attribute groups. All fields are optional unless otherwise noted.
Represents the personal and foundational attributes of the individual practitioner.
| Embedded Cluster | Attribute | Type | Description |
|---|---|---|---|
| Names | use | Code Set | Name usage (e.g., official, nickname) |
prefix | Text | Honorific prefix (e.g., Dr., Mr.) | |
first | Text | First name | |
middle | Text | Middle name or initial | |
last | Text | Last name or surname | |
suffix | Text | Suffix (e.g., Jr., III) | |
credential | Text | Professional credentials or designation | |
| Dates of Birth | dateOfBirth | Date | Date of birth of the practitioner |
| Gender & Identity | gender | Code Set | Administrative gender |
genderIdentity | Code Set | Self‑identified gender | |
| Personal Attributes | ssn | Text | Social Security Number |
citizenship | Code Set | Citizenship status | |
photos | Text | URLs to practitioner images or profile photos | |
sexualOrientation | Code Set | Self-identified sexual orientation | |
race | Code Set | Race classification | |
ethnicity | Code Set | Ethnicity classification | |
religiousAffiliation | Code Set | Religious affiliation | |
maritalStatus | Code Set | Marital status | |
| Death Details | deceased | Boolean | Deceased indicator |
deathDetails | Object | Death-related details (Date, Location, etc.) |
Represents legal permissions and communication settings.
| Embedded Cluster | Attribute | Type | Description |
|---|---|---|---|
| Consents | name | Text | Consent name |
type | Code Set | Consent type | |
status | Code Set | Consent status | |
isRequired | Boolean | Required indicator | |
decision | Code Set | Consent decision | |
validFrom | Date | Valid from | |
validTo | Date | Valid to | |
source | Text | Source of consent | |
regulatoryBasis | Code Set | Regulatory basis | |
| Preferences | name | Text | Preference name |
type | Text | Preference type | |
| Channels | type | Code Set | Communication channel (e.g., SMS, Email) |
isOptedIn | Boolean | Opt‑in indicator | |
lastOptedInDate | Date | Last opt‑in date | |
frequency | Text | Communication frequency | |
preferredStartTime | Time | Preferred start time | |
preferredEndTime | Time | Preferred end time |
Captured as grouped records or standalone communication attributes.
| Embedded Cluster | Attribute | Type | Description |
|---|---|---|---|
| Address | Address | - | Physical or mailing address |
| Phone List | Phone List | - | One or more phone numbers |
| Fax List | Fax List | - | Fax numbers |
| Best Time to Contact | day | Code Set | Day of the week for the contact window |
startTime | Time | Start time of preferred contact window | |
endTime | Time | End time of preferred contact window | |
allDay | Boolean | Indicates availability for the entire day |
Detailed attributes for physical locations.
| Embedded Cluster | Attribute | Type | Description |
|---|---|---|---|
addressName | Text | Address label | |
addressType | Code Set | Address type | |
line1 | Text | Address line 1 | |
line2 | Text | Address line 2 | |
city | Text | City | |
district | Text | District | |
state | Text | State | |
postalCode | Text | Postal code | |
country | Text | Country | |
latitude | Number | Latitude | |
longitude | Number | Longitude | |
validFrom | Date | Start date | |
validTo | Date | End date |
Standard communication channels.
| Embedded Cluster | Attribute | Type | Description |
|---|---|---|---|
| Phone Numbers | number | Text | Phone number |
type | Code Set | Phone type | |
| Fax Numbers | number | Text | Fax number |
type | Code Set | Fax type | |
| Emails | email | Text | Email address |
type | Code Set | Email type | |
validFrom | Date | Start date | |
validTo | Date | End date |
Identifiers related to the practitioner’s legal and professional standing.
| Embedded Cluster | Attribute | Type | Description |
|---|---|---|---|
| NPI | npi | Text | National Provider Identifier |
entityTypeCode | Text | NPI entity type (Type 1) | |
| Licenses | number | Text | License number |
state | Text | Issuing state | |
taxonomyCode | Code Set | Taxonomy code | |
licenseEffectiveDate | Date | Effective date | |
licenseExpirationDate | Date | Expiration date | |
licenseStatus | Text | Status | |
licenseStatusDetail | Text | Status detail | |
licenseProfessionCode | Text | Profession code | |
licenseRankCode | Text | Rank code | |
licenseLastUpdateDate | Date | Last update | |
licenseDescription | Text | Profession description | |
licenseType | Text | License type | |
licensePrimary | Text | Primary indicator | |
| Specialties | taxonomyCode | Code Set | Specialty taxonomy code |
Represents clinical service modes, programs, and availability.
| Embedded Cluster | Attribute | Type | Description |
|---|---|---|---|
acceptingNewPatients | Boolean | Indicates current patient acceptance | |
serviceMode | Code Set | Service delivery mode (e.g., virtual) | |
| Clinical Expertise | name | Text | Area of expertise |
url | Text | Reference URL | |
| Programs | name | Text | Program name |
url | Text | Reference URL | |
| Specialties | taxonomyCode | Code Set | Specialty taxonomy code |
isPrimary | Boolean | Primary specialty indicator | |
| Sub-Specialties | code | Code Set | Sub-specialty code |
status | Code Set | Active status indicator | |
| Availability | day | Code Set | Day of the week |
startTime | Time | Availability start time | |
endTime | Time | Availability end time | |
allDay | Boolean | Availability for the full day | |
| Accepted Insurances | payerName | Text | Insurance payer name |
status | Code Set | Participation status | |
insuranceType | Code Set | Type of insurance | |
planId | Text | Plan identifier | |
planType | Code Set | Plan classification | |
networkStatus | Code Set | Network status (In/Out) | |
startDate | Date | Participation start date | |
endDate | Date | Participation end date |
Education, practice background, and external identifiers.
| Embedded Cluster | Attribute | Type | Description |
|---|---|---|---|
| Qualifications | type | Code Set | Qualification type |
qualification | Text | Qualification name | |
status | Code Set | Status | |
issuer | Text | Issuer | |
issueDate | Date | Issue date | |
validFrom | Date | Valid from | |
validTo | Date | Valid to | |
| Medicare & Compliance | Medicare Info | Object | PECOS and Medicare status |
Disciplinary Info | Object | Warnings or exclusions | |
| Education | school | Text | Medical school |
year | Number | Graduation year | |
| Background | practiceYears | Number | Estimated years in practice |
research | Text | Interests and publications | |
locationInfo | Text | Rural / urban indicators | |
| Languages | language | Code Set | Spoken/Written language |
preferred | Boolean | Preferred language indicator | |
| Alternate Identifiers | description | Text | Label for the identifier |
type | Code Set | Identifier type | |
value | Text | Identifier value | |
status | Text | Current status | |
issuer | Text | Issuing authority | |
issueDate | Date | Issue date | |
startDate | Date | Validity start date | |
endDate | Date | Validity end date | |
| External Unique ID | issuer | Text | Issuing authority or system |
value | Text | Unique identifier value | |
status | Text | Identifier status | |
startDate | Date | Validity start date | |
endDate | Date | Validity end date |