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provider county

prvdr_cnty
provider·Updated Jun 23, 2026

Definition

ISO-11179 Definition

The county or county-equivalent geographic area in which a healthcare provider primary practice location is situated, used in network adequacy analysis and geographic access to care measurement. County is a critical geographic unit for Medicare Advantage network adequacy because CMS evaluates provider access at the county level in service area filings. Rural counties often have fewer providers per capita, creating network adequacy challenges that require health plans to establish exception processes or telehealth alternatives.

Healthcare data teams use prvdr_cnty with FIPS county codes as VARCHAR(5) in network adequacy models, joining provider location data to CMS county-level standards tables to identify gaps in specialty access, and in population health analytics to correlate provider supply with member health outcomes across geographic areas.

Standard Abbreviation

prvdr_cnty

Category

provider

Production DDL — DIM_PROVIDER

DIM_PROVIDER.sql
CREATE OR REPLACE TABLE DIM_PROVIDER (
    prvdr_key           INTEGER        NOT NULL  -- surrogate key,
    prvdr_npi           VARCHAR(10)              -- NPI number,
    prvdr_tin           VARCHAR(10)              -- tax ID number,
    prvdr_first_nm      VARCHAR(100)             -- first name,
    prvdr_last_nm       VARCHAR(100)             -- last name,
    prvdr_org_nm        VARCHAR(255)             -- organization name,
    prvdr_typ_cd        VARCHAR(20)              -- provider type code,
    prvdr_spclty_cd     VARCHAR(10)              -- specialty code,
    prvdr_tax           VARCHAR(10)              -- taxonomy code,
    prvdr_state_cd      CHAR(2)                  -- state code,
    prvdr_zip_cd        VARCHAR(10)              -- zip code,
    prvdr_ntwk_sts      VARCHAR(10)              -- network status,
    prvdr_accpt_pt_ind  CHAR(1)                  -- accepting patients,
    prvdr_excl_ind      CHAR(1)                  -- exclusion indicator,
    load_dt             TIMESTAMP_NTZ  NOT NULL  -- load timestamp
);

Standard Snowflake DDL for the canonical provider table. Convert to BigQuery or Databricks →

Why This Term Matters

Provider data management is one of the most operationally complex data domains in healthcare because providers move, merge, and update their credentials continuously. A data engineer who understands provider terminology can build NPI validation, credentialing, and network adequacy pipelines that keep provider directories accurate and prevent claim rejections. Stale or incorrect provider data is a leading cause of prior authorization delays and CMS compliance findings.

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