# Practitioner02 - Data Exchange For Quality Measures Implementation Guide v1.0.0-ballot

## Example Practitioner: Practitioner02

Language: en; 

Information Source: [http://example.org/fhir/server](http://example.org/fhir/server)

Profile: [QICore Practitioner](http://hl7.org/fhir/us/qicore/STU7.0.1/StructureDefinition-qicore-practitioner.html)

**identifier**: Provider number/1234567893 (use: official, period: 2005-07-16 09:00:00-0500 --> (ongoing))

**active**: true

**name**: Emile Zieme(Official)

**telecom**: ph: 8605555555(Work), ph: 8605555555(Work)

**address**: UCONN MEDICAL GROUP, FARMINGTON, CT 060300001(home)

**gender**: Male

**birthDate**: 1964-06-19



## Resource Content

```json
{
  "resourceType" : "Practitioner",
  "id" : "practitioner02",
  "meta" : {
    "source" : "http://example.org/fhir/server",
    "profile" : ["http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-practitioner"]
  },
  "language" : "en",
  "identifier" : [{
    "use" : "official",
    "type" : {
      "coding" : [{
        "system" : "http://terminology.hl7.org/CodeSystem/v2-0203",
        "code" : "PRN",
        "display" : "Provider number"
      }]
    },
    "system" : "http://hl7.org/fhir/sid/us-npi",
    "value" : "1234567893",
    "period" : {
      "start" : "2005-07-16T09:00:00-05:00"
    },
    "assigner" : {
      "display" : "www.cms.gov"
    }
  }],
  "active" : true,
  "name" : [{
    "use" : "official",
    "text" : "Emile Zieme",
    "family" : "Zieme",
    "given" : ["Emile"],
    "suffix" : ["M.D."]
  }],
  "telecom" : [{
    "system" : "phone",
    "value" : "8605555555",
    "use" : "work",
    "rank" : 1
  },
  {
    "system" : "phone",
    "value" : "8605555555",
    "use" : "work",
    "rank" : 2
  }],
  "address" : [{
    "extension" : [{
      "extension" : [{
        "url" : "latitude",
        "valueDecimal" : 41.791776
      },
      {
        "url" : "longitude",
        "valueDecimal" : -72.718832
      }],
      "url" : "http://hl7.org/fhir/StructureDefinition/geolocation"
    }],
    "use" : "home",
    "type" : "both",
    "text" : "UCONN MEDICAL GROUP, FARMINGTON, CT 060300001",
    "line" : ["UCONN MEDICAL GROUP"],
    "city" : "FARMINGTON",
    "state" : "CT",
    "postalCode" : "060300001",
    "country" : "USA"
  }],
  "gender" : "male",
  "birthDate" : "1964-06-19"
}

```
