provider group npi
prvdr_grp_npiDefinition
ISO-11179 Definition
The Type 2 National Provider Identifier assigned to a healthcare provider group or organization, as distinct from the Type 1 NPI assigned to individual practitioners. Group NPIs are used when multiple providers practice under a shared organizational entity and bill collectively rather than individually. The group NPI appears on claims when the organizational entity is the billing provider, while the rendering provider NPI identifies the individual practitioner who delivered the service.
CMS requires both group and rendering NPIs on Medicare claims when services are performed under a group practice arrangement. Healthcare data teams maintain the relationship between individual provider NPIs and group NPIs in provider hierarchy tables, use prvdr_grp_npi in claims analytics to aggregate performance and cost metrics at the group level, and in network contracting to manage group participation agreements.
Standard Abbreviation
prvdr_grp_npi
Category
Production DDL — DIM_PROVIDER
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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