Da Vinci Payer Data Exchange
2.0.0 - STU2 United States of America flag

This page is part of the Da Vinci Payer Data Exchange (v2.0.0: STU2) based on FHIR (HL7® FHIR® Standard) R4. This is the current published version. For a full list of available versions, see the Directory of published versions

US Core PractitionerRole

Previous Page - US Core Practitioner

The US Core PractitionerRole profile SHALL be used to record information about the roles that practitioners take in providing services to their patients.

The essential fields (Must Support or Cardinality greater than 0..*) to be provided in the US Core PractitionerRole resource are:

R4 Element Name Cardinality Type
PractitionerRole.practitioner practitioner 1..1 Reference(US Core Practitioner Profile)
PractitionerRole.organization organization 1..1 Reference(US Core Organization Profile)
PractitionerRole.code code 0..* CodeableConcept
PractitionerRole.specialty specialty 0..* CodeableConcept
PractitionerRole.location location 0..* Reference(Location)
PractitionerRole.telecom telecom 0..* ContactPoint
PractitionerRole.telecom.system system 1..1 code
PractitionerRole.telecom.value value 1..1 string
PractitionerRole.endpoint endpoint 0..* Reference(Endpoint)

Table Definition

Example PractitionerRole Resource

An example mapping of an PractitionerRole resource is shown here:

{
  "resourceType" : "Bundle",
  "id" : "66c8856b-ba11-4876-8aa8-467aad8c11a2",
  "type" : "searchset",
  "total" : 1,
  "link" : [
    {
      "relation" : "self",
      "url" : "http://52.90.126.238:8080/fhir/baseDstu3/PractitionerRole?_id=PractitionerRole-1&_include=PractitionerRole%3Apractitioner&_include=PractitionerRole%3Aendpoint"
    }
  ],
  "entry" : [
    {
      "fullUrl" : "http://52.90.126.238:8080/fhir/baseDstu3/PractitionerRole/PractitionerRole-1",
      "resource" : {
        "resourceType" : "PractitionerRole",
        "id" : "PractitionerRole-1",
        "meta" : {
          "profile" : [
            "http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitionerrole"
          ]
        },
        "text" : {
          "status" : "generated",
          "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\">
Generated Narrative with Details
id: PractitionerRole-1
meta: 
practitioner: <a href=\"Practitioner/Practitioner-1011\">Brenda Jennings Richard MD</a>
organization: <a href=\"Organization-acme-lab.html\">Acme Lab. Generated Summary: id: acme-lab; 1144221847, 2523423456; active; <span title=\"Codes: {http://terminology.hl7.org/CodeSystem/organization-type prov}\">Healthcare Provider</span>; name: Acme Labs; ph: (+1) 734-677-7777, hq@acme.org</a>
code: Primary Care <span style=\"background: LightGoldenRodYellow\">(Details : {http://nucc.org/provider-taxonomy code '261QP2300X' = 'Primary Care', given as 'Primary Care'})</span>
specialty: General Practice <span style=\"background: LightGoldenRodYellow\">(Details : {http://nucc.org/provider-taxonomy code '208D00000X' = 'General Practice', given as 'General Practice'})</span>
location: <a href=\"Location-hl7east.html\">Health Level Seven International. Generated Summary: id: hl7east; 29; status: active; name: Health Level Seven International - Amherst; description: HL7 Headquarters - East; ph: (+1) 734-677-7777</a>
endpoint: 
  • <a href=\"http://52.90.126.238:8080/fhir/baseDstu3/Endpoint/Endpoint-71\">Westwood Physicians Organization ADT</a>
  • <a href=\"http://52.90.126.238:8080/fhir/baseDstu3/Endpoint/Endpoint-71\">Brenda.Jennings.Richard.MD@direct.example.org</a>
</div>"
        },
        "practitioner" : {
          "reference" : "Practitioner/Practitioner-1011",
          "display" : "Brenda Jennings Richard MD"
        },
        "organization" : {
          "reference" : "Organization/acme-lab",
          "display" : "Acme Lab"
        },
        "code" : [
          {
            "coding" : [
              {
                "system" : "http://nucc.org/provider-taxonomy",
                "code" : "261QP2300X",
                "display" : "Primary Care"
              }
            ]
          }
        ],
        "specialty" : [
          {
            "coding" : [
              {
                "system" : "http://nucc.org/provider-taxonomy",
                "code" : "208D00000X",
                "display" : "General Practice"
              }
            ]
          }
        ],
        "location" : [
          {
            "reference" : "Location/hl7east",
            "display" : "Health Level Seven International"
          }
        ],
        "endpoint" : [
          {
            "reference" : "http://52.90.126.238:8080/fhir/baseDstu3/Endpoint/Endpoint-71",
            "display" : "Westwood Physicians Organization ADT"
          },
          {
            "reference" : "http://52.90.126.238:8080/fhir/baseDstu3/Endpoint/Endpoint-71",
            "display" : "Brenda.Jennings.Richard.MD@direct.example.org"
          }
        ]
      },
      "search" : {
        "mode" : "match"
      }
    },
    {
      "fullUrl" : "http://52.90.126.238:8080/fhir/baseDstu3/Practitioner/Practitioner-1011",
      "resource" : {
        "resourceType" : "Practitioner",
        "id" : "Practitioner-1011",
        "meta" : {
          "profile" : [
            "http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitioner"
          ]
        },
        "text" : {
          "status" : "generated",
          "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\">
Generated Narrative with Details
id: Practitioner-1011
meta: 
identifier: US Social Security Number = 000001011 (OFFICIAL), US National Provider Identifier = 9999991011 (OFFICIAL), Michigan Common Key Service Identifier = d46f70565a1042f6a6ece48dd81b408f (OFFICIAL)
name: Brenda Jennings Richard 
telecom: ph: 313-555-6868(HOME), ph: 313-555-6443(WORK)
address: 346 W Plum Avenu Dearborn MI 48123
gender: female
birthDate: Nov 15, 1976
Qualifications
<table class=\"grid\">-IdentifierCodeIssuer*Michigan Medical License = LARA-1011 (OFFICIAL)Medical Doctor <span style=\"background: LightGoldenRodYellow\">(Details : {http://michigan.gov/lara/license-type code '4305' = '4305', given as 'Medical Doctor'})</span>Michigan Department of Licensing and Regulatory Affairs</table></div>"
        },
        "identifier" : [
          {
            "use" : "official",
            "type" : {
              "coding" : [
                {
                  "system" : "http://terminology.hl7.org/CodeSystem/identifier-type",
                  "code" : "SB",
                  "display" : "Social Beneficiary Identifier"
                }
              ],
              "text" : "US Social Security Number"
            },
            "system" : "http://hl7.org/fhir/sid/us-ssn",
            "value" : "000001011"
          },
          {
            "use" : "official",
            "type" : {
              "coding" : [
                {
                  "system" : "http://terminology.hl7.org/CodeSystem/v2-0203",
                  "code" : "PRN",
                  "display" : "Provider number"
                }
              ],
              "text" : "US National Provider Identifier"
            },
            "system" : "http://hl7.org/fhir/sid/us-npi",
            "value" : "9999991011"
          },
          {
            "use" : "official",
            "type" : {
              "coding" : [
                {
                  "system" : "http://terminology.hl7.org/CodeSystem/identifier-type",
                  "code" : "SB",
                  "display" : "Social Beneficiary Identifier"
                }
              ],
              "text" : "Michigan Common Key Service Identifier"
            },
            "system" : "http://mihin.org/fhir/cks",
            "value" : "d46f70565a1042f6a6ece48dd81b408f"
          }
        ],
        "name" : [
          {
            "family" : "Richard",
            "given" : [
              "Brenda",
              "Jennings"
            ],
            "suffix" : [
              "MD"
            ]
          }
        ],
        "telecom" : [
          {
            "system" : "phone",
            "value" : "313-555-6868",
            "use" : "home"
          },
          {
            "system" : "phone",
            "value" : "313-555-6443",
            "use" : "work"
          }
        ],
        "address" : [
          {
            "text" : "346 W Plum Avenu Dearborn MI 48123",
            "line" : [
              "346 W Plum Avenue"
            ],
            "city" : "Dearborn",
            "state" : "MI",
            "postalCode" : "48126"
          }
        ],
        "gender" : "female",
        "birthDate" : "1976-11-15",
        "qualification" : [
          {
            "identifier" : [
              {
                "use" : "official",
                "type" : {
                  "coding" : [
                    {
                      "system" : "http://terminology.hl7.org/CodeSystem/v2-0203",
                      "code" : "MD",
                      "display" : "Medical License number"
                    }
                  ],
                  "text" : "Michigan Medical License"
                },
                "system" : "http://michigan.gov/fhir/medical-license",
                "value" : "LARA-1011",
                "assigner" : {
                  "display" : "State of Michigan"
                }
              }
            ],
            "code" : {
              "coding" : [
                {
                  "system" : "http://michigan.gov/lara/license-type",
                  "code" : "4305",
                  "display" : "Medical Doctor"
                }
              ]
            },
            "issuer" : {
              "display" : "Michigan Department of Licensing and Regulatory Affairs"
            }
          }
        ]
      },
      "search" : {
        "mode" : "include"
      }
    },
    {
      "fullUrl" : "http://52.90.126.238:8080/fhir/baseDstu3/Endpoint/Endpoint-71",
      "resource" : {
        "resourceType" : "Endpoint",
        "id" : "71",
        "text" : {
          "status" : "generated",
          "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\">
Generated Narrative with Details
id: 71
status: active
connectionType: Direct Project (Details: http://terminology.hl7.org/CodeSystem/endpoint-connection-type code direct-project = 'Direct Project', stated as 'null')
name: Brenda.Jennings.Richard.MD@direct.example.org
managingOrganization: <a href=\"Organization-acme-lab.html\">Generated Summary: id: acme-lab; 1144221847, 2523423456; active; <span title=\"Codes: {http://terminology.hl7.org/CodeSystem/organization-type prov}\">Healthcare Provider</span>; name: Acme Labs; ph: (+1) 734-677-7777, hq@acme.org</a>
payloadType: urn:hl7-org:sdwg:ccda-structuredBody:1.1 <span style=\"background: LightGoldenRodYellow\">(Details : {urn:oid:1.3.6.1.4.1.19376.1.2.3 code 'urn:hl7-org:sdwg:ccda-structuredBody:1.1' = 'urn:hl7-org:sdwg:ccda-structuredBody:1.1)</span>
payloadMimeType: text/xml
address: <a href=\"mailto:Brenda.Jennings.Richard.MD@direct.example.org\">Brenda.Jennings.Richard.MD@direct.example.org</a>
</div>"
        },
        "status" : "active",
        "connectionType" : {
          "system" : "http://terminology.hl7.org/CodeSystem/endpoint-connection-type",
          "code" : "direct-project"
        },
        "name" : "Brenda.Jennings.Richard.MD@direct.example.org",
        "managingOrganization" : {
          "reference" : "Organization/acme-lab"
        },
        "payloadType" : [
          {
            "coding" : [
              {
                "system" : "urn:oid:1.3.6.1.4.1.19376.1.2.3",
                "code" : "urn:hl7-org:sdwg:ccda-structuredBody:1.1"
              }
            ]
          }
        ],
        "payloadMimeType" : [
          "text/xml"
        ],
        "address" : "mailto:Brenda.Jennings.Richard.MD@direct.example.org"
      },
      "search" : {
        "mode" : "include"
      }
    }
  ]
}

Refer to the US Core Additional examples of the US Core R4 Implementation Guide for further examples of completed US Core Practitioner Profiles .

Next Page - PDex Prior Authorization