For AI agents: the documentation index is at /docs/payerbox/llms.txt. A Markdown version of this page is available at /docs/payerbox/data-integration/uscdi/care-team.md or by requesting it with the Accept: text/markdown header.
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Care Team Members

Datasets

US Core 6.1.0 maps each USCDI data element onto a FHIR element.

DatasetUS Core 6.1.0 target profile(s)
practitionersUS Core Practitioner, US Core PractitionerRole
organizationsUS Core Organization
care_teamUS Core CareTeam

practitioners

One row per practitioner, organization, and location: each row becomes one PractitionerRole, so a clinician practising at two locations produces two rows. Multiple specialties at the same location share a row.

If you already send the Provider Directory feed, list here only the clinicians missing from it, such as an external ordering physician.

practitioners.csv Data template with example rows
ColumnRequiredFormat / valuesExample
npiYes10 digits, Luhn-valid over the 80840 prefix, or another stable id with practitioner_identifier_system9999999995
practitioner_identifier_systemIf npi is not an NPIURI of the issuing system, a URL you control or an OID; NPI (http://hl7.org/fhir/sid/us-npi) assumed when emptyhttp://acme.org/provider-ids
last_nameYestextRoe
first_nameRecommendedtextRichard
specialty_nuccRecommendedNUCC taxonomy code(s), ;-separated Healthcare Provider Taxonomy207R00000X
primary_org_identifierRecommendedkey from organizations9999999979
practitioner_role_codeRecommendedSNOMED CT or v3 participation-function code Care Team Member FunctionPCP primary care physician
location_idRecommendedlocations keyLOC-221
phoneRecommended10 digits5551234567
emailIf availableemail address
role_period_startIf availabledate2021-04-01
role_period_endIf availabledate
is_deletedIf retractingtrue retracts this rowtrue
  • A clinician without an NPI, an out-of-state consultant or a reviewer a utilization-management vendor knows only internally, may be identified by another stable id; then practitioner_identifier_system names who issued it, the same way it works for organizations. US Core requires a Practitioner to carry an identifier and a family name, so a clinician sent as a bare name cannot be published.
  • A row is keyed by npi, location_id and practitioner_role_code together — the roster has no key of its own, so do not mint one. Keep those three stable and the role updates in place.

organizations

One row per organization, defined once: an in-network facility is its Provider Directory facilities row; every other organization a *_org_identifier column names, including the plan issuer, is a row here. A directory-only sender ships this one file with the directory.

organizations.csv Data template with example rows
ColumnRequiredFormat / valuesExample
org_identifierYesNPI, NAIC company code, CLIA number or your own id, see identifier options; unique across the dataset9999999979
org_identifier_systemIf org_identifier is not an NPIURI of the issuing system, see identifier options; NPI assumed when emptyurn:oid:2.16.840.1.113883.6.300
org_nameYestextFamily Medical Group
activeRecommendedtrue / false (true assumed when empty); false retires an organization without deleting ittrue
org_type_codeIf availableprov provider, pay payer, ins insurance company, dept hospital department, bus non-healthcare business organization-typeprov
telecom_codeRecommendedphone, fax, email, pager, url, sms, other contact-point-systemphone
telecom_valueRecommendedthe number, address, or URL itself5551234567
address_line1Recommendedtext225 Broadway
cityRecommendedtextNew York
stateRecommended2-letter USPS USPS statesNY
zipRecommended5 or 9 digits, as a string10007
is_deletedIf retractingtrue retracts this rowtrue
  • Every *_org_identifier column in every feed carries this org_identifier value as is; the system is declared once, here.

Organization identifier options

Identifierorg_identifierorg_identifier_systemTypical organization
NPI10 digits, Luhn-valid over the 80840 prefixempty, or http://hl7.org/fhir/sid/us-npipractice, hospital, pharmacy
NAIC company code5 digitsurn:oid:2.16.840.1.113883.6.300insurer, plan issuer
CLIA number10 characters, D in the third positionurn:oid:2.16.840.1.113883.4.7clinical laboratory
Your own idany stable stringa URL you control or an OIDanything else

NPI, CLIA number and NAIC company code are the identifiers US Core Organization expects; Plan-Net, CARIN BB and PAS organizations expect the same three.

  • telecom_code and telecom_value travel together: FHIR requires the system code whenever a contact value is sent, so a telecom_value with an empty telecom_code is rejected.
  • FHIR requires name and active on every Organization, so a row without org_name is rejected, and an empty active is taken as true.

care_team

One row per patient and team member.

care_team.csv Data template with example rows
ColumnRequiredFormat / valuesExample
patient_identifierYespatient keyMBR0000012
member_npiYes, unless member_related_person_id is sent10 digits, Luhn-valid over the 80840 prefix9999999995
member_related_person_idYes, unless member_npi is sentrecord_id of the related_persons row, for non-cliniciansRP-3310
role_codeYesSNOMED CT or v3 participation-function code Care Team Member Function446050000 primary care physician
statusRecommendedproposed, active, suspended, inactive, entered-in-error care-team-statusactive
is_deletedIf retractingtrue retracts this rowtrue
  • A row is keyed by patient_identifier, the member (member_npi or member_related_person_id) and role_code together — a roster has no key of its own for a membership, so do not mint one. Keep those stable and the membership updates in place.

These resources are served by Patient Access, Provider Access, and Payer-to-Payer.

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