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provider state code

prvdr_state_cd
provider·Updated Jun 23, 2026

Definition

ISO-11179 Definition

The two-character USPS state abbreviation identifying the state in which a healthcare provider primary practice location is situated and where the provider holds an active state professional license. Provider state code determines which state licensing board has jurisdiction over the provider, which state-specific scope of practice laws apply, and which state network adequacy regulations govern health plan contracting requirements. Providers practicing across state lines must hold licenses in each state of practice.

Healthcare data teams use prvdr_state_cd in network adequacy analysis to segment provider supply by state, in credentialing workflows to validate state license status through primary source verification, and in claims adjudication to apply correct state-specific fee schedules and coverage rules for services rendered across state boundaries.

Standard Abbreviation

prvdr_state_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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