provider type code
prvdr_typ_cdDefinition
ISO-11179 Definition
A standardized code classifying a healthcare provider into a broad category based on the type of services delivered and the organizational structure of the practice. CMS and NUCC maintain provider type taxonomies used in the NPI registry and claims processing. Common provider type codes distinguish individual practitioners from organizational providers, and further classify by setting such as physician, mid-level practitioner, hospital, skilled nursing facility, home health agency, ambulance service, and durable medical equipment supplier.
Provider type code drives claims adjudication rules, fee schedule assignment, and network adequacy measurement. Healthcare data teams use prvdr_typ_cd in provider master data tables to apply correct reimbursement logic, segment provider directories by care setting, and produce CMS-required network adequacy reports stratified by provider type.
Standard Abbreviation
prvdr_typ_cd
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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