| Name | Description | Type | Additional information |
|---|---|---|---|
| provider_id | globally unique identifier |
None. |
|
| display_txt | string |
None. |
|
| last_name_txt | string |
None. |
|
| first_name_txt | string |
None. |
|
| active_ind | boolean |
None. |
|
| address_1_txt | string |
None. |
|
| address_2_txt | string |
None. |
|
| city_txt | string |
None. |
|
| state_txt | string |
None. |
|
| zip_txt | string |
None. |
|
| npi_txt | string |
None. |
|
| secondary_id_txt | string |
None. |
|
| secondary_id_type_txt | string |
None. |
|
| federal_tax_id_type_txt | string |
None. |
|
| federal_tax_id_txt | string |
None. |
|
| taxonomy_cd_txt | string |
None. |
|
| default_billing_provider_id | globally unique identifier |
None. |
|
| billing_provider_ind | boolean |
None. |
|
| rendering_provider_ind | boolean |
None. |
|
| referring_provider_ind | boolean |
None. |
|
| phone_txt | string |
None. |
|
| note_txt | string |
None. |
|
| created_dt | date |
None. |
|
| created_by | globally unique identifier |
None. |
|
| updated_dt | date |
None. |
|
| updated_by | globally unique identifier |
None. |
|
| fax_txt | string |
None. |
|
| practice_name_txt | string |
None. |
|
| email_address_txt | string |
None. |
|
| signature_dat | string |
None. |
|
| meaningful_phase_ind | integer |
None. |
|
| provider_type | string |
None. |
|
| direct_address | string |
None. |
|
| direct_password_txt | string |
None. |
|
| PatientCareTeams | Collection of PatientCareTeamModel |
None. |
|
| ProviderInsurances | Collection of ProviderInsuranceModel |
None. |
|
| ProviderInsurances1 | Collection of ProviderInsuranceModel |
None. |