| tAddresses |
NPI |
National Provider Identifier (unique National Provider Identifier assigned to healthcare providers by the US Department of Health and Human Services) |
Relational Key
The NPI is a unique 10-digit numerical code assigned to every HIPAA-covered healthcare provider, including individuals and organizations, by the U.S. Department of Human Services, Centers for Medicare and Medicaid Services (CMS).
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| (Provider addresses; MDB and CSV formats) |
Mail1stAddr |
Provider First Line Business Mailing Address |
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| Mail2ndAddr |
Provider Second Line Business Mailing Address |
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| MailCity |
Provider Business Mailing Address City Name
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| MailState |
Provider Business Mailing Address State Name |
The federal data contains variations on state codes, abbreviations and full state names; we conform this field to standard 2-character state codes where possible.
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| MailZip |
Provider Business Mailing Address Postal Code (most are 9-digit Zip Codes) |
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| MailCountry |
Provider Business Mailing Address Country Code (If outside U.S.) |
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| Prac1stAddr |
Provider First Line Business Practice Location Address |
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| Prac2ndAddr |
Provider Second Line Business Practice Location Address |
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| PracCity |
Provider Business Practice Location Address City Name |
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| PracState |
Provider Business Practice Location Address State Name |
The federal data contains variations on state codes, abbreviations and full state names; we conform this field to standard 2-character state codes where possible.
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| PracZip |
Provider Business Practice Location Address Postal Code (most are 9-digit Zip Codes) |
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| PracCountry |
Provider Business Practice Location Address Country Code (If outside U.S.)
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| tEntity |
NPI |
National Provider Identifier |
Relational Key |
| (Provider entity and record information; MDB and CSV formats) |
EntityType |
Entity Type Code |
Type 1 indicates an individual provider (i.e., physician, psychologist, etc.); Type 2 indicates an organizational provider (i.e., hospital, lab, pharmacy, etc.)
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| ReplacementNPI |
Replacement NPI |
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| EIN |
Employer Identification Number (EIN) |
CMS is not yet providing tax numbers of this type |
| EnumDate |
Provider Enumeration Date |
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| UpdateDate |
Last Update Date |
Date this provider NPI record was last updated |
| DeactReason |
NPI Deactivation Reason Code |
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| DeactDate |
NPI Deactivation Date |
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| ReactDate |
NPI Reactivation Date |
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| Gender |
Provider Gender Code |
M or F for Type 1 providers |
| IsSoleProp |
Is Sole Proprietor |
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| IsOrgSubpart |
Is Organization Subpart |
For Type 2 providers, may be one of several organizational units, each with its own NPI number
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| ParentOrgTIN |
Parent Organization TIN |
CMS is not yet providing tax numbers of this type
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| InPECOS |
From monthly CMS PECOS distributions of PECOS-enrolled providers.. Source: PECOS file distribution, linkage derived algorithmically* beginning with December 2011 release. |
Y= provider is enrolled in PECOS (eligible to bill Medicare); N = not enrolled. Uppercase Y indicates exact NPI match in PECOS history; lowercase y indicates algorithmic match without historical verification.
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| Warning |
From the Office of Inspector General's excluded providers database (LEIE). A warning in this field should not be taken as definitive; the user should check the tExcluded table and consider other sources of provider fraud and exclusion information.
(Algorithmically derived*).
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Y= elements in the providers record indicated a match with a listing in the federal excluded providers database (see the table tExcluded below)
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| ExclType |
The exclusion type from the LEIE database, explaining the reason that a provider was barred from billing Medicare. Fields with a Y in the Warning field will display this code.
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The code's definition can be found at this link. A CSV file listing these exclusion descriptions is included in the CarePrecise Access Complete CSV download file.
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| UPIN |
Obsolete physician identifier, still used in some legacy systems. Sources: NPPES and LEIE.
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Where available
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| Group |
From NPPES group taxonomy data. |
Y= this provider reported that it operates as either a multi-specialty group or single-specialty group.
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| tHumanNames |
NPI |
National Provider Identifier |
Relational Key |
| (Provider human names, esp. Type 1 individual providers; MDB and CSV formats) |
LN |
Provider Last Name (Legal Name) |
The enumerated provider's name |
| FN |
Provider First Name |
| MN |
Provider Middle Name |
| PN |
Provider Name Prefix Text |
| SN |
Provider Name Suffix Text |
| Cred |
Provider Credential Text |
| OthLN |
Provider Other Last Name |
"AKA" name: Nee name, nickname, etc. |
| OthFN |
Provider Other First Name |
| OthMN |
Provider Other Middle Name |
| OthPN |
Provider Other Name Prefix Text |
| OthSN |
Provider Other Name Suffix Text |
| OthCred |
Provider Other Credential Text |
| OthLNType |
Provider Other Last Name Type Code |
| AuthLN |
Authorized Official Last Name |
Name of the provider's authorizing official, if other than the listed individual provider. For organizations, this is the contact name.
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| AuthFN |
Authorized Official First Name |
| AuthMN |
Authorized Official Middle Name |
| AuthTitle |
Authorized Official Title or Position |
| AuthPN |
Authorized Official Name Prefix Text |
| AuthSN |
Authorized Official Name Suffix Text |
| AuthCred |
Authorized Official Credential Text
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| tOID |
NPI |
National Provider Identifier |
Relational Key |
| (Other identifiers, such as UPIN, OSCAR, PIN, Medicaid, etc., excluding NPI and taxonomy codes; MDB and CSV formats) |
OtherID |
Other Provider Identifier_[1 through 50] |
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| OtherIDType |
Other Provider Identifier Type Code_ [1 through 50] |
| Description |
OtherIDType |
| Other |
1 |
| Medicare UPIN |
2 |
| Medicare ID-Type Unspecified |
4 |
| Medicaid |
5 |
| Medicare OSCAR/CERTIFICATION |
6 |
| Medicare NSC |
7 |
| Medicare PIN |
8 |
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| OtherIDState |
Other Provider Identifier State_ [1 through 50] |
In the case of a state license code, this is the licensing state |
| OtherIDIssuer |
Other Provider Identifier Issuer_ [1 through 50] |
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| OIDnum |
Source: Added by CarePrecise to indicate the original NPPES flat file Other Identifiers field number. |
The number of the NPPES Other Identifier field (1 through 50)
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| tOrgNames |
NPI |
National Provider Identifier |
Relational Key |
(Provider organization names, esp. Type 2 providers; MDB and CSV formats)
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OrgName_LBN |
Provider Organization Name (Legal Business Name) |
LBN |
| OthOrgName |
Provider Other Organization Name |
Other |
| OthOrgNameType |
Provider Other Organization Name Type Code |
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| ParentOrgLBN |
Parent Organization LBN
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| tPhoneFax |
NPI |
National Provider Identifier |
Relational Key |
(Provider phone and fax numbers; MDB and CSV formats)
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MailPhone |
Provider Business Mailing Address Telephone Number |
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| MailFax |
Provider Business Mailing Address Fax Number |
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| PracPhone |
Provider Business Practice Location Address Telephone Number |
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| PracFax |
Provider Business Practice Location Address Fax Number |
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| AuthPhone |
Authorized Official Telephone Number
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| tTaxo |
NPI |
National Provider Identifier |
Relational Key |
(Provider Taxonomy codes indicating specialties and subspecialties for Type 1/individual providers, and facility types for Type 2/organization providers; MDB and CSV formats)
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Taxo |
Healthcare Provider Taxonomy Code_[1 through 15] |
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| Lic |
Provider License Number_[1 through 15] |
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| LicState |
Provider License Number State Code_[1 through 15] |
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| TaxoSwitch |
Healthcare Provider Primary Taxonomy Switch_[1 through 15] |
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| Tnum |
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The number of the NPPES taxonomy field (1 through 15)
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| TaxoDescr |
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Taxonomy code description (the specialty/subspecialty in English)
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| tTaxoGroups |
NPI |
National Provider Identifier |
Relational Key |
| NEW: Beginning with December 2011 distribution. (Provider Taxonomy codes indicating group practices; MDB and CSV formats) |
Gnum |
The source data (NPPES) permits group codes to be reported in up to 15 fields in this section. CarePrecise creates a 1-to-many table, listing each of a provider's reported txonomy group codes in a separate record. The Gnum is the NPPES Group Taxonomy field number in which the code was reported, allowing the code be matched with the specific group specialty in the tTaxo table. For instance, a code in tTaxoGroup field Gnum 3 indicates a group practice of the specialty reported in Tnum 3 in the tTaxo table.
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This is the newest of the data released by CMS in the NPPES file. This is where the group taxonomy codes are reported. CMS does not report the codes in the taxonomy section (which appear in our tTaxo table) because they represent an additional layer of information on any one or more of the tTaxo codes.
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| |
TaxoGroup |
Healthcare Provider Taxonomy Group_[1 through 15] |
193200000X for a multi-specialty practice
193400000X for a single-specialty practice
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tCoLoCode |
NPI |
National Provider Identifier |
Relational Key |
| NEW: Beginning with January 2012 distribution (the December 2012 data update). (MDB and CSV formats) |
CoLoCode |
Provider co-location code (algorithmically derived*). The NPI and CoLoCode comprise the dual relational key for this table. The NPI identifies the provider record, and the CoLoCode identifies the co-located group. The CoLoCode is an up to 40-character string that stands in for detailed location data, and is not intended to be sensical to the human viewer. The CoLoCode /Group Practice system is in beta and subject to change, although code assignment per location is designed to remain static month-to-month (i.e., a given practice group's code would remain the same from month-to-month, while members' codes would change as they move to different practice groups) unless the group's location changes, as the code is predicated on practice location.
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This code is an algorithmically derived conformation of the provider's practice location, permitting identification of providers who practice at the same location, for instance, physician groups, dental groups, radiology groups, etc. By using this table in conjunction with the tTaxoGroups table, it is possible to visualize the group entity (generally an organization) and its provider members.
Although each provider should have only one primary practice location in our database, technically, the tCoLoCode table is 1-to-many, because our system may not be able to resolve a single practice location per provider. There may be up to two distinct CoLoCodes for some providers.
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| Count |
Count of providers matching this co-location (algorithmically derived conformation of the provider's practice location; see tCoLoCodes above). Indicates the number of providers practicing at this co-location.
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|
| tAdded |
NPI |
National Provider Identifier |
Relational Key |
(MDB and CSV formats)
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DateDiscovered |
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The CarePrecise processing date on which the added provider record was discovered. Corresponds to the most recent previous CMS update date on which the added provider data was included in the NPPES database.
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| tDropped |
NPI |
National Provider Identifier |
Relational Key |
(MDB and CSV formats)
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DateDiscovered |
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The CarePrecise processing date on which it was discovered that the provider record was dropped from the NPPES database. Corresponds to the most recent previous CMS update date on which the provider data was dropped from the NPPES database.
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| EntityType |
Entity Type Code |
Type 1 is individual providers (i.e., physicians, psychologists, etc.); Type 2 is organizational providers (i.e., hospitals, labs, etc.)
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| ProvName |
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This is a generated field based on EntityType.
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| Prac1stAddr |
Provider First Line Business Practice Location Address |
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| Prac2ndAddr |
Provider Second Line Business Practice Location Address |
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| PracCity |
Provider Business Practice Location Address City Name |
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| PracState |
Provider Business Practice Location Address State Name |
The federal data contains variations on state codes, abbreviations and full state names; we conform this field to standard 2-character state codes. A small number of non-US postal addresses remain nonconforming.
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| PracZip |
Provider Business Practice Location Address Postal Code |
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| PracCountry |
Provider Business Practice Location Address Country Code (If outside U.S.) |
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| PracPhone |
Provider Business Practice Location Address Telephone Number |
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| EnumDate |
Provider Enumeration Date |
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| UpdateDate |
Last Update Date |
Date this provider NPI record was last updated
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tExcluded
|
LN |
Last name (Type 1 providers) |
This table, sourced from the LEIE, lists all provider records in the federal excluded providers database. A provider may be excluded (barred from billing Medicare) for reasons of a criminal nature, among other reasons. This table contains no relational key; however, it is used to produce the Warning field in the tEntity table, which does include the provider's NPI. This table should be referenced for backup information.
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| (MDB and CSV formats) |
FN |
First name (Type 1 providers) |
| MN |
Middle Name (Type 1 providers) |
| OrgName |
Organization name (Type 2 providers) |
| Addr |
Street address |
| City |
City |
| State |
State |
| Zip |
Zip Code |
| DOB |
Date of Birth (currently unpopulated) |
| General |
Provider category |
| Specialty |
Provider specialty |
| UPIN |
Federal physician identifier code (legacy) |
| ExclType |
Exclusion type (why provider was excluded) |
| ExclDesc |
Exclusion Description |
| ExclDate |
Date provider was excluded (YYYYMMDD)
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| Additional data included only in CarePrecise Gold (from USPS, U.S. Department of Commerce, and independent CarePrecise research): |
tZips
Economic and social segmentation data for providers' service areas
(This table is included only in CarePrecise Gold; MDB format) |
ZipCode |
5-digit Zip Code |
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| Wealth |
Numerical indicator of the relative wealth/poverty of the provider's immediate service area (zip). Wealth/poverty level is show as a percentage of the Federal Poverty Level (FPL) for the particular geographic area. Currently up to 12 levels are present in the data; additional levels will be included when data for those more extreme wealth levels are present. |
| Description |
Wealth Level |
| =<50% FPL |
1 |
| 50% to 100% FPL |
2 |
| 100% to 150% FPL |
3 |
| 150% to 200% FPL |
4 |
| 200% to 300% FPL |
5 |
| 300% to 500% FPL |
6 |
| 500% to 700% FPL |
7 |
| 700% to 1000% FPL |
8 |
| 1000% to 1500% FPL |
9 |
| 1500% to 2000% FPL |
10 |
| 2000% to 3000% FPL |
11 |
| Greater than 3000% FPL |
12 |
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| RuralUrban |
Indicates Rural (R), Urban (U) or Other (O) status for the provider's immediate service area (zip). Other indicates suburban or small city status. |
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| City |
City associated with Zip Code |
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| County |
County primarily associated with Zip Code |
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| State |
State associated with Zip Code
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Additional data tables:
- Names
- Names_Company
- Names_Cred
- Names_Generize
- Names_Prefices
- Names_Suffices
- StateNameVariants
(These tables are included only in CarePrecise Gold; MDB format) |
Additional data tables included in CarePrecise Gold are used by the included SharpMail™ tool to produce correctly cased names and addresses and correctly genderized and prefixed salutations. |
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* Algorithmically derived data in the CPAC dataset includes data that is extracted/mined from the source databases, but which has a margin of error and should not be relied upon as conclusive. Record linking algorithms are used to enrich our data when direct correlation (via a unique identifier field) is not available, using available information in name, address, phone, taxonomy, and other fields. In particular, the data on providers excluded from billing Medicare (from the federal LEIE database) can only be linked to NPI records by this means. In like manner, the available federal data does not provide information on providers' practice groups; using record-linkage technology, we can extrapolate the groups assuming that providers sharing the same practice location are members of the group reported at that location, and these group data can be corroborated or enriched with the group practice codes provided by CMS.
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