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Health Care Provider Characteristics Codes LAST UPDATED 7/1/2015

This code list is for use with health care provider information for enrollment and credentialing transactions and their corresponding responses. It is intended to provide codified responses to questions presented to a health care provider applying to or registering with an entity and to report the outcome of such application or registration. It may also be used for responses to inquiries regarding provider participation or registration in a program or plan.

Filter Codes by Status: Show All Current | To Be Deactivated | Deactivated

10Provider has a medical condition that impairs or limits him/her to practice
Start: 01/01/2004
11Provider receives public funding
Start: 01/01/2004
12This is a multi-specialty group
Start: 01/01/2004 | Stop: 10/01/2005
13This is a primary care group
Start: 01/01/2004
14Provider has ownership or financial interest in another medical establishment
Start: 01/01/2004
15Professional liability coverage has been restricted/terminated/or modified
Start: 01/01/2004
16This is the provider’s primary insurance coverage
Start: 01/01/2004
17This is the provider’s excess insurance coverage
Start: 01/01/2004
18Excess insurance coverage exists for this provider
Start: 01/01/2004
19Provider is self-insured
Start: 01/01/2004
1AProvider’s self-insurance is funded
Start: 01/01/2004
1BProvider’s self-insurance is not funded
Start: 01/01/2004
1CProvider has had adverse action on state license, certificate, or registration
Start: 01/01/2004
1DProvider has had adverse action on DEA or other applicable narcotic registration
Start: 01/01/2004
1EProvider has had adverse action on hospital or other health care facility staff membership for privileges
Start: 01/01/2004
1FProvider has had adverse action on professional organization membership
Start: 01/01/2004
1GProvider has had adverse action on Medicare, Medicaid or other government health programs
Start: 01/01/2004
1HProvider has had adverse action on any prepaid health plan or managed care participation
Start: 01/01/2004
1IProvider has had adverse action with respect to educational or training institution or program
Start: 01/01/2004
1JProvider has had adverse action by professional society or association
Start: 01/01/2004
1KProvider is under health plan administrative sanction
Start: 01/01/2004
1LProvider accepts Workers’ Compensation
Start: 01/01/2004
1MProvider accepts Medicare assignment
Start: 01/01/2004
1NProvider accepts Medicaid assignment
Start: 01/01/2004
1OProvider participates in Medicare and accepts assignment
Start: 01/01/2004
1PProvider participates in Medicaid and accepts assignment
Start: 01/01/2004
1QProvider is not accepting new patients for obstetric care
Start: 01/01/2004
1RThis location is handicapped accessible
Start: 01/01/2004
1SThis location is less than 1 block from public transportation
Start: 01/01/2004
1TThis location is less than 5 blocks from public transportation
Start: 01/01/2004
1UThis location is less than 1 mile from public transportation
Start: 01/01/2004
1VThis location is 1 or more miles from public transportation
Start: 01/01/2004
1WThis location has a full time assistant available
Start: 01/01/2004
1XThis location has a part time assistant available
Start: 01/01/2004
1YThis location has Telecommunication Device for the Deaf (TDD) equipment
Start: 01/01/2004
1ZThis location is medically fragile equipped
Start: 01/01/2004
20This location employs para-professional staff/employees
Start: 01/01/2004
21This location maintains para-professional credentialing, licensure & malpractice information
Start: 01/01/2004
22This location admits and cares for patients on its own hospital service
Start: 01/01/2004
23The scheduling time for urgent care at this location is more than 24 hours
Start: 01/01/2004
24The scheduling time for symptomatic care at this location is more than 72 hours
Start: 01/01/2004
25The scheduling time for routine visits at this location is more than 7 days
Start: 01/01/2004
26The scheduling time for preventive routine care at this location is more than 30 days
Start: 01/01/2004
27The waiting time at this location is more than 30 minutes from time of scheduled appointment
Start: 01/01/2004
28Allergy skin testing is provided at this location
Start: 01/01/2004
29Asthma treatment is provided at this location
Start: 01/01/2004
2AEKG services are provided at this location
Start: 01/01/2004
2BFlexible sigmoidoscopy is provided at this location
Start: 01/01/2004
2CIV hydration/treatment is provided at this location
Start: 01/01/2004
2DLaceration repair is provided at this location
Start: 01/01/2004
2ELaboratory services/testing is provided at this location
Start: 01/01/2004
2FMassage therapy is provided at this location
Start: 01/01/2004
2GMinor fracture work is provided at this location
Start: 01/01/2004
2HMinor surgery is provided at this location
Start: 01/01/2004
2IOccupational therapy is provided at this location
Start: 01/01/2004
2JGynecology services are provided at this location
Start: 01/01/2004
2KObstetric services are provided at this location
Start: 01/01/2004
2LOsteopathic manipulation is provided at this location
Start: 01/01/2004
2MPhysical therapy is provided at this location
Start: 01/01/2004
2NPulmonary function studies are provided at this location
Start: 01/01/2004
2OSpeech pathology is provided at this location
Start: 01/01/2004
2PHearing tests are provided at this location
Start: 01/01/2004
2QVisual screenings are provided at this location
Start: 01/01/2004
2RMammography services are provided at this location
Start: 01/01/2004
2SX-rays are provided at this location
Start: 01/01/2004
2TThis hospital has a Medicare Prospective Payment System (PPS) exempt rehabilitation unit
Start: 01/01/2004
2UThis hospital has a Medicare Prospective Payment System (PPS) exempt psychiatric unit
Start: 01/01/2004
2VAssistive aid information not collected from the provider
Start: 10/01/2006
55Accepted
Start: 01/01/2004
56Unspecified Error
Start: 01/01/2004
57Failed Field Edits
Start: 01/01/2004
58Minimum Fields Missing
Start: 01/01/2004
59Exact Duplicate
Start: 01/01/2004
5ARejected by NPI Enumerator
Start: 01/01/2004
5BInvalid Taxonomy Code
Start: 01/01/2004
5CTaxonomy Code Mismatch
Start: 01/01/2004
5DSSN Validation Error
Start: 01/01/2004
5EMailing Address Error
Start: 01/01/2004
5FLocation Address Error
Start: 01/01/2004
5GNPI not on File
Start: 01/01/2004
5HInvalid Deactivation Reason Code
Start: 01/01/2004
5IPended by GateKeeper
Start: 01/01/2004
5JPended by L/S/T
Start: 01/01/2004
5KDuplicate record
Start: 01/01/2004
5LSchema validation failed
Start: 01/01/2004
5MIndividual Verification – Found
Start: 01/01/2004
5NIndividual Verification - Not Found
Start: 01/01/2004
5OIndividual Verification - Close Match
Start: 01/01/2004
5PIndividual Verification – Insufficient Data
Start: 01/01/2004
5QOrganization Verification – Found
Start: 01/01/2004
5ROrganization Verification - Not Found
Start: 01/01/2004
5SOrganization Verification – Close Match
Start: 01/01/2004
5TOrganization Verification - Insufficient Data
Start: 01/01/2004
5UIndividual Data Dissemination - Fulfilled
Start: 01/01/2004
5VIndividual Data Dissemination - Not Fulfilled
Start: 01/01/2004
5WOrganization Data Dissemination - Fulfilled
Start: 01/01/2004
5XOrganization Data Dissemination - Not Fulfilled
Start: 01/01/2004
5YUnspecified Response
Start: 01/01/2004