Health Care Provider Characteristics Codes

11 Provider receives public funding
Effective 1/1/2004
13 This is a primary care provider
Effective 1/1/2004
14 Provider has ownership or financial interest in another medical establishment
Effective 1/1/2004
15 Professional liability coverage has been restricted/terminated/or modified
Effective 1/1/2004
16 This is the provider’s primary insurance coverage
Effective 1/1/2004
17 This is the provider’s excess insurance coverage
Effective 1/1/2004
18 Excess insurance coverage exists for this provider
Effective 1/1/2004
19 Provider is self-insured
Effective 1/1/2004
1A Provider’s self-insurance is funded
Effective 1/1/2004
1B Provider’s self-insurance is not funded
Effective 1/1/2004
1C Provider has had adverse action on state license, certificate, or registration
Effective 1/1/2004
1D Provider has had adverse action on DEA or other applicable narcotic registration
Effective 1/1/2004
1E Provider has had adverse action on hospital or other health care facility staff membership for privileges
Effective 1/1/2004
1F Provider has had adverse action on professional organization membership
Effective 1/1/2004
1G Provider has had adverse action on Medicare, Medicaid or other government health programs
Effective 1/1/2004
1H Provider has had adverse action on any prepaid health plan or managed care participation
Effective 1/1/2004
1I Provider has had adverse action with respect to educational or training institution or program
Effective 1/1/2004
1J Provider has had adverse action by professional society or association
Effective 1/1/2004
1K Provider is under health plan administrative sanction
Effective 1/1/2004
1L Provider accepts Workers’ Compensation
Effective 1/1/2004
1M Provider accepts Medicare assignment
Effective 1/1/2004
1N Provider accepts Medicaid assignment
Effective 1/1/2004
1O Provider participates in Medicare and accepts assignment
Effective 1/1/2004
1P Provider participates in Medicaid and accepts assignment
Effective 1/1/2004
1Q Provider is not accepting new patients for obstetric care
Effective 1/1/2004
1R This location is handicapped accessible
Effective 1/1/2004
1S This location is less than 1 block from public transportation
Effective 1/1/2004
1T This location is less than 5 blocks from public transportation
Effective 1/1/2004
1U This location is less than 1 mile from public transportation
Effective 1/1/2004
1V This location is 1 or more miles from public transportation
Effective 1/1/2004
1W This location has a full time assistant available
Effective 1/1/2004
1X This location has a part time assistant available
Effective 1/1/2004
1Y This location has Telecommunication Device for the Deaf  (TDD) equipment
Effective 1/1/2004
1Z This location is medically fragile equipped
Effective 1/1/2004
20 This location employs para-professional staff/employees  
Effective 1/1/2004
21 This location maintains para-professional credentialing, licensure & malpractice information
Effective 1/1/2004
22 This location admits and cares for patients on its own hospital service
Effective 1/1/2004
23 The scheduling time for urgent care at this location is more than 24 hours  
Effective 1/1/2004
24 The scheduling time for symptomatic care at this location is more than 72 hours
Effective 1/1/2004
25 The scheduling time for routine visits at this location is more than 7 days
Effective 1/1/2004
26 The scheduling time for preventive routine care at this location is more than 30 days
Effective 1/1/2004
27 The waiting time at this location is more than 30 minutes from time of scheduled appointment
Effective 1/1/2004
28 Allergy skin testing is provided at this location
Effective 1/1/2004
29 Asthma treatment is provided at this location
Effective 1/1/2004
2A EKG services are provided at this location
Effective 1/1/2004
2B Flexible sigmoidoscopy is provided at this location
Effective 1/1/2004
2C IV hydration/treatment is provided at this location
Effective 1/1/2004
2D Laceration repair is provided at this location
Effective 1/1/2004
2E Laboratory services/testing is provided at this location
Effective 1/1/2004
2F Massage therapy is provided at this location
Effective 1/1/2004
2G Minor fracture work is provided at this location
Effective 1/1/2004
2H Minor surgery is provided at this location
Effective 1/1/2004
2I Occupational therapy is provided at this location
Effective 1/1/2004
2J Gynecology services are provided at this location
Effective 1/1/2004
2K Obstetric services are provided at this location
Effective 1/1/2004
2L Osteopathic manipulation is provided at this location
Effective 1/1/2004
2M Physical therapy is provided at this location
Effective 1/1/2004
2N Pulmonary function studies are provided at this location
Effective 1/1/2004
2O Speech pathology is provided at this location
Effective 1/1/2004
2P Hearing tests are provided at this location
Effective 1/1/2004
2Q Visual screenings are provided at this location
Effective 1/1/2004
2R Mammography services are provided at this location
Effective 1/1/2004
2S X-rays are provided at this location
Effective 1/1/2004
2T This hospital has a Medicare Prospective Payment System (PPS) exempt rehabilitation unit
Effective 1/1/2004
2U This hospital has a Medicare Prospective Payment System (PPS) exempt psychiatric unit
Effective 1/1/2004
10 Provider has a medical condition that impairs or limits him/her to practice
Effective 1/1/2004
55 Accepted
Effective 1/1/2004
56 Unspecified Error
Effective 1/1/2004
57 Failed Field Edits
Effective 1/1/2004
58 Minimum Fields Missing
Effective 1/1/2004
59 Exact Duplicate
Effective 1/1/2004
5A Rejected by NPI Enumerator
Effective 1/1/2004
5B Invalid Taxonomy Code
Effective 1/1/2004
5C Taxonomy Code Mismatch
Effective 1/1/2004
5D SSN Validation Error
Effective 1/1/2004
5E Mailing Address Error
Effective 1/1/2004
5F Location Address Error
Effective 1/1/2004
5G NPI not on File
Effective 1/1/2004
5H Invalid Deactivation Reason Code
Effective 1/1/2004
5I Pended by GateKeeper
Effective 1/1/2004
5J Pended by L/S/T
Effective 1/1/2004
5K Duplicate record
Effective 1/1/2004
5L Schema validation failed
Effective 1/1/2004
5M Individual Verification – Found
Effective 1/1/2004
5N Individual Verification - Not Found
Effective 1/1/2004
5O Individual Verification - Close Match
Effective 1/1/2004
5P Individual Verification – Insufficient Data
Effective 1/1/2004
5Q Organization Verification – Found
Effective 1/1/2004
5R Organization Verification - Not Found
Effective 1/1/2004
5S Organization Verification – Close Match
Effective 1/1/2004
5T Organization Verification - Insufficient Data
Effective 1/1/2004
5U Individual Data Dissemination - Fulfilled
Effective 1/1/2004
5V Individual Data Dissemination - Not Fulfilled
Effective 1/1/2004
5W Organization Data Dissemination - Fulfilled
Effective 1/1/2004
5X Organization Data Dissemination - Not Fulfilled
Effective 1/1/2004
5Y Unspecified Response
Effective 1/1/2004
2V Assistive aid information not collected from the provider
Effective 10/1/2006
6A This provider is a free-standing laboratory
Effective 7/1/2018
5Z This location is a retail health center
Effective 7/1/2018
6B This provider is a free-standing imaging center
Effective 7/1/2018
6C This is a mobile provider that travels to the location of a patient and does not have a specific service address
Effective 7/1/2018
6D This location is an urgent care center
Effective 7/1/2018
6E This provider offers telehealth services
Effective 7/1/2018
6J This provider offers testing for COVID-19
Effective 4/1/2020
6K This provider offers a vaccine for COVID-19
Effective 1/1/2021
6F Medication–assisted Treatment (MAT) for Opioid Use Disorders is provided at this location
Effective 1/1/2019
6G Physician authorized to dispense Medication–assisted Treatment (MAT) for Opioid Use Disorders
Effective 1/1/2019
6H This location is a certified Opioid Treatment Program
Effective 1/1/2019
6I Counseling for Opioid Use Disorders is provided at this location
Effective 1/1/2019
6L This provider offers only virtual services
Effective 4/1/2021
6M Provider may be in contract renegotiations
Effective 4/1/2021
6N Durable medical equipment & medical supplies related to patient mobility assistance is available at this location
Effective 4/1/2021
6O Durable medical equipment & medical supplies related to blood sugar maintenance is available at this location
Effective 4/1/2021
6P Durable medical equipment & medical supplies related to patient bedding is available at this location
Effective 4/1/2021
6Q Durable medical equipment & medical supplies related to sleep apnea is available at this location
Effective 4/1/2021
6R Durable medical equipment & medical supplies related to infusion therapy is available at this location
Effective 4/1/2021
6S This location provides only laboratory specimen collection, not onsite testing services
Effective 4/1/2021
6T This provider offers a vaccine for influenza
Effective 4/1/2021
6U This provider offers mass immunizations
Effective 4/1/2021
6V Qualified medical interpreter services are provided at this location
Effective 4/1/2021
6W No appointment is required at this location
Effective 4/1/2021
6X This provider offers concierge services for a special fee
Effective 4/1/2021
6Y This provider is an Essential Community Provider
Effective 4/1/2021
6Z This provider is an Essential Access Community Hospital
Effective 4/1/2021
7A This provider is an Indian Health Service (IHS)/Tribal 638/Urban Indian Provider
Effective 4/1/2021
7B This provider has an area of focus in Attention Deficit Disorders (ADD/ADHD)
Effective 4/1/2021
7C This provider has an area of focus in adoption related services
Effective 4/1/2021
7D This provider has an area of focus in anxiety and panic disorders
Effective 4/1/2021
7E This provider has an area of focus in dialectical behavioral therapy
Effective 4/1/2021
7F This provider has an area of focus in bipolar disorders/manic depressive illness
Effective 4/1/2021
7G This provider has an area of focus in depression
Effective 4/1/2021
7H This provider has an area of focus in personality disorders
Effective 4/1/2021
7I This provider has an area of focus in schizophrenia disorders
Effective 4/1/2021
7J This provider has an area of focus in autism spectrum disorders
Effective 4/1/2021
7K This provider has an area of focus in behavioral therapy for autism spectrum disorders
Effective 4/1/2021
7L This provider has an area of focus in bariatric psych assessment
Effective 4/1/2021
7M This provider has an area of focus in eating disorders
Effective 4/1/2021
7N This provider has an area of focus in behavior modification
Effective 4/1/2021
7O This provider has an area of focus in cognitive behavioral therapy (CBT)
Effective 4/1/2021
7P This provider has an area of focus in Solution-Focused Brief Therapy
Effective 4/1/2021
7Q This provider has an area of focus in chemical dependency/chemical dependency assessment
Effective 4/1/2021
7R This provider has an area of focus in faith counseling
Effective 4/1/2021
7S This provider has an area of focus in compulsive gambling
Effective 4/1/2021
7T This provider has an area of focus in cultural issues
Effective 4/1/2021
7U This provider has an area of focus in divorce and blended family issues
Effective 4/1/2021
7V This provider has an area of focus in family therapy
Effective 4/1/2021
7W This provider has an area of focus in group therapy
Effective 4/1/2021
7X This provider has an area of focus in electroconvulsive therapy
Effective 4/1/2021
7Y This provider has an area of focus in sexual orientation issues
Effective 4/1/2021
7Z This provider has an area of focus in medication management
Effective 4/1/2021
8A This provider has an area of focus in neuropsychological testing
Effective 4/1/2021
8B This provider has an area of focus in psychological testing
Effective 4/1/2021
8C This provider has an area of focus in obsessive compulsive disorder
Effective 4/1/2021
8D This provider has an area of focus in pain management
Effective 4/1/2021
8E This provider has an area of focus in transgender issues
Effective 4/1/2021
8F This provider has an area of focus in sexual disorders
Effective 4/1/2021
8G This provider has an area of focus in abuse, assault and trauma
Effective 4/1/2021
8H This provider has an area of focus in post-traumatic stress disorder (PTSD)
Effective 4/1/2021
8I This provider has an area of focus in HIV/AIDS issues
Effective 4/1/2021
8J This provider has an area of focus in men's issues
Effective 4/1/2021
8K This provider has an area of focus in women's issues
Effective 4/1/2021
8L This provider has an area of focus in prenatal issues
Effective 4/1/2021
8M This provider has an area of focus in postpartum issues
Effective 4/1/2021
8N This provider has an area of focus in fertility
Effective 4/1/2021
8O This provider has an area of focus in geriatrics
Effective 4/1/2021
8P This provider has an area of focus in end of life issues
Effective 4/1/2021
8Q This provider offers treatment or rehabilitation to individuals with substance use disorders in an inpatient residential setting
Effective 4/1/2021
8R This provider offers intensive inpatient treatment to individuals with substance use disorders for crisis stabilization in a hospital setting, usually for less than 30 days
Effective 4/1/2021
8S This provider offers intensive treatment to individuals with substance use disorders to prevent hospitalization or as continuation of treatment following an inpatient hospitalization. Patients attend sessions for usually six or more hours a day most days
Effective 4/1/2021
8T This provider offers treatment to individuals with substance use disorders in an outpatient clinic or private office setting
Effective 4/1/2021
8U This provider offers outpatient treatment that is less intensive than partial hospitalization to individuals with substance use disorders. Patients live independently and attend sessions for usually three to four hours a day
Effective 4/1/2021
8V This provider offers treatment or rehabilitation to individuals with behavioral or mental health disorders in an inpatient residential setting
Effective 4/1/2021
8W This provider offers intensive inpatient treatment to individuals with behavioral or mental health disorders for crisis stabilization in a hospital setting, usually for less than 30 days
Effective 4/1/2021
8X This provider offers intensive treatment to individuals with behavioral or mental health disorders to prevent hospitalization or as continuation of treatment following an inpatient hospitalization. Patients attend sessions for usually six or more hours a day most days of the week
Effective 4/1/2021
8Y This provider offers treatment to individuals with behavioral or mental health disorders in an outpatient clinic or private office setting
Effective 4/1/2021
8Z This provider offers outpatient treatment that is less intensive than partial hospitalization to individuals with behavioral or mental health disorders. Patients live independently and attend sessions for usually three to four hours a day
Effective 4/1/2021
9A This provider offers services that meet the social, cultural, and linguistic needs of persons
Effective 4/1/2021
9B This location offers access that complies with the Americans with Disabilities Act, including any applicable amendments
Effective 4/1/2021
9C This location is accessible to public transportation
Effective 4/1/2021
9D This provider offers the capability to communicate when intended recipient is not immediately available
Effective 4/1/2021
9E This provider offers services for visually impaired persons
Effective 4/1/2021
9F This provider offers services for cognitively impaired persons
Effective 4/1/2021
9G This location offers services for mobility impaired persons
Effective 4/1/2021