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provider facility type

prvdr_fac_typ_cd
provider·Updated Jun 23, 2026

Definition

ISO-11179 Definition

A standardized code classifying a healthcare facility into a defined category based on the services offered, patient population served, and regulatory classification. Common facility type codes include acute care hospital, critical access hospital, ambulatory surgery center, skilled nursing facility, long-term acute care hospital, inpatient rehabilitation facility, federally qualified health center, rural health clinic, and behavioral health facility. Facility type drives claims adjudication rules including applicable fee schedules, billing code sets, and cost reporting requirements.

CMS applies different payment methodologies by facility type such as IPPS for acute hospitals, OPPS for outpatient departments, and RUG rates for skilled nursing facilities. Healthcare data teams use prvdr_fac_typ_cd in claims routing, network adequacy measurement by facility category, and regulatory reporting requiring facility type stratification.

Standard Abbreviation

prvdr_fac_typ_cd

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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