The NPI of the provider. This must be all digits [0-9] and exactly 10 characters long.
Whether the provider can be used to render services.
Whether the provider can be used to bill services.
Whether the provider is an individual (NPPES Type 1) or organization (NPPES Type 2) provider.
The type of license that the provider holds.
Auto-generated ID set on creation.
Qualification given to a provider (PTAN, Medicaid Provider Id etc.).
The first name of the provider, if the provider is an individual.
The last name of the provider, if the provider is an individual.
The name of the provider, if the provider is an organization.
If the provider has a contract with insurance, this must be the same tax ID given to the payer on an IRS W-9 form completed during contracting.
A code designating classification and specialization.
The addresses associated with this provider.
The employment start date for the provider.
The employment termination date for the provider.