# Practitioner (Type-1)

## Overview

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.

## When to Use This Domain

* **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.


## Relationship to Other Domains

* **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.


## Data Model

The Practitioner schema is composed of professional, demographic, and administrative attribute groups. All fields are optional unless otherwise noted.

### Core Identity & Demographics

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.) |


### Consents & Preferences

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 |


### Contact Information (Grouped)

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 |


### Standalone Addresses

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 |


### Phone, Fax, and Email

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 |


### Professional Identifiers

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 |


### Practitioner Roles & Participation

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 |


### Additional Attributes

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 |