PackagesCanonicalsLogsProblems
    Packages
    hl7.fhir.us.carin-bb@1.0.0
    http://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-Practitioner
{
  "description": "This profile builds upon the US Core Practitioner profile. It is used to convey information about the practitioner who provided to the patient services described on the claim.",
  "_filename": "StructureDefinition-C4BB-Practitioner.json",
  "package_name": "hl7.fhir.us.carin-bb",
  "date": "2020-11-23T17:26:16+00:00",
  "derivation": "constraint",
  "publisher": "HL7 Financial Management Working Group",
  "fhirVersion": "4.0.1",
  "jurisdiction": [ {
    "coding": [ {
      "code": "US",
      "system": "urn:iso:std:iso:3166"
    } ]
  } ],
  "name": "C4BBPractitioner",
  "mapping": [ {
    "uri": "http://hl7.org/v2",
    "name": "HL7 v2 Mapping",
    "identity": "v2"
  }, {
    "uri": "http://hl7.org/v3",
    "name": "RIM Mapping",
    "identity": "rim"
  }, {
    "uri": "http://www.omg.org/spec/ServD/1.0/",
    "name": "ServD",
    "identity": "servd"
  }, {
    "uri": "http://hl7.org/fhir/fivews",
    "name": "FiveWs Pattern Mapping",
    "identity": "w5"
  } ],
  "abstract": false,
  "type": "Practitioner",
  "experimental": null,
  "resourceType": "StructureDefinition",
  "title": "C4BB Practitioner",
  "package_version": "1.0.0",
  "snapshot": {
    "element": [ {
      "constraint": [ {
        "key": "dom-2",
        "human": "If the resource is contained in another resource, it SHALL NOT contain nested Resources",
        "xpath": "not(parent::f:contained and f:contained)",
        "source": "http://hl7.org/fhir/StructureDefinition/DomainResource",
        "severity": "error",
        "expression": "contained.contained.empty()"
      }, {
        "key": "dom-3",
        "human": "If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource",
        "xpath": "not(exists(for $id in f:contained/*/f:id/@value return $contained[not(parent::*/descendant::f:reference/@value=concat('#', $contained/*/id/@value) or descendant::f:reference[@value='#'])]))",
        "source": "http://hl7.org/fhir/StructureDefinition/DomainResource",
        "severity": "error",
        "expression": "contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()"
      }, {
        "key": "dom-4",
        "human": "If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated",
        "xpath": "not(exists(f:contained/*/f:meta/f:versionId)) and not(exists(f:contained/*/f:meta/f:lastUpdated))",
        "source": "http://hl7.org/fhir/StructureDefinition/DomainResource",
        "severity": "error",
        "expression": "contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()"
      }, {
        "key": "dom-5",
        "human": "If a resource is contained in another resource, it SHALL NOT have a security label",
        "xpath": "not(exists(f:contained/*/f:meta/f:security))",
        "source": "http://hl7.org/fhir/StructureDefinition/DomainResource",
        "severity": "error",
        "expression": "contained.meta.security.empty()"
      }, {
        "key": "dom-6",
        "human": "A resource should have narrative for robust management",
        "xpath": "exists(f:text/h:div)",
        "source": "http://hl7.org/fhir/StructureDefinition/DomainResource",
        "severity": "warning",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice",
          "valueBoolean": true
        }, {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice-explanation",
          "valueMarkdown": "When a resource has no narrative, only systems that fully understand the data can display the resource to a human safely. Including a human readable representation in the resource makes for a much more robust eco-system and cheaper handling of resources by intermediary systems. Some ecosystems restrict distribution of resources to only those systems that do fully understand the resources, and as a consequence implementers may believe that the narrative is superfluous. However experience shows that such eco-systems often open up to new participants over time."
        } ],
        "expression": "text.`div`.exists()"
      }, {
        "key": "Practitioner-identifier",
        "human": "Practitioner.identifier must include an NPI or a Tax ID",
        "source": "http://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-Practitioner",
        "severity": "error",
        "expression": "identifier.where(type.where(coding.where(code in ('npi' | 'TAX')).exists()).exists()).exists()"
      } ],
      "path": "Practitioner",
      "min": 0,
      "definition": "This is basic constraint on provider for use in US Core resources.",
      "isModifier": false,
      "short": "A person with a  formal responsibility in the provisioning of healthcare or related services",
      "mapping": [ {
        "map": "Entity. Role, or Act",
        "identity": "rim"
      }, {
        "map": "PRD (as one example)",
        "identity": "v2"
      }, {
        "map": "Role",
        "identity": "rim"
      }, {
        "map": "Provider",
        "identity": "servd"
      } ],
      "mustSupport": false,
      "alias": [ "Provider" ],
      "max": "*",
      "id": "Practitioner",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Practitioner"
      },
      "isSummary": false
    }, {
      "path": "Practitioner.id",
      "min": 0,
      "definition": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
      "isModifier": false,
      "short": "Logical id of this artifact",
      "type": [ {
        "code": "http://hl7.org/fhirpath/System.String",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
          "valueUrl": "string"
        } ]
      } ],
      "max": "1",
      "id": "Practitioner.id",
      "comment": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Resource.id"
      },
      "isSummary": true
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "source": "http://hl7.org/fhir/StructureDefinition/Element",
        "severity": "error",
        "expression": "hasValue() or (children().count() > id.count())"
      } ],
      "path": "Practitioner.meta",
      "min": 1,
      "definition": "The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.",
      "isModifier": false,
      "short": "Metadata about the resource",
      "type": [ {
        "code": "Meta"
      } ],
      "mustSupport": true,
      "max": "1",
      "id": "Practitioner.meta",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Resource.meta"
      },
      "isSummary": true
    }, {
      "path": "Practitioner.meta.id",
      "min": 0,
      "definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
      "isModifier": false,
      "short": "Unique id for inter-element referencing",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "http://hl7.org/fhirpath/System.String",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
          "valueUrl": "string"
        } ]
      } ],
      "representation": [ "xmlAttr" ],
      "max": "1",
      "id": "Practitioner.meta.id",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Element.id"
      },
      "isSummary": false
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "source": "http://hl7.org/fhir/StructureDefinition/Element",
        "severity": "error",
        "expression": "hasValue() or (children().count() > id.count())"
      }, {
        "key": "ext-1",
        "human": "Must have either extensions or value[x], not both",
        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
        "source": "http://hl7.org/fhir/StructureDefinition/Extension",
        "severity": "error",
        "expression": "extension.exists() != value.exists()"
      } ],
      "path": "Practitioner.meta.extension",
      "min": 0,
      "definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
      "isModifier": false,
      "short": "Additional content defined by implementations",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      } ],
      "slicing": {
        "rules": "open",
        "description": "Extensions are always sliced by (at least) url",
        "discriminator": [ {
          "path": "url",
          "type": "value"
        } ]
      },
      "type": [ {
        "code": "Extension"
      } ],
      "alias": [ "extensions", "user content" ],
      "max": "*",
      "id": "Practitioner.meta.extension",
      "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Element.extension"
      },
      "isSummary": false
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "source": "http://hl7.org/fhir/StructureDefinition/Element",
        "severity": "error",
        "expression": "hasValue() or (children().count() > id.count())"
      } ],
      "path": "Practitioner.meta.versionId",
      "min": 0,
      "definition": "The version specific identifier, as it appears in the version portion of the URL. This value changes when the resource is created, updated, or deleted.",
      "isModifier": false,
      "short": "Version specific identifier",
      "type": [ {
        "code": "id"
      } ],
      "max": "1",
      "id": "Practitioner.meta.versionId",
      "comment": "The server assigns this value, and ignores what the client specifies, except in the case that the server is imposing version integrity on updates/deletes.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Meta.versionId"
      },
      "isSummary": true
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "source": "http://hl7.org/fhir/StructureDefinition/Element",
        "severity": "error",
        "expression": "hasValue() or (children().count() > id.count())"
      } ],
      "path": "Practitioner.meta.lastUpdated",
      "min": 1,
      "definition": "When the resource last changed - e.g. when the version changed.",
      "isModifier": false,
      "short": "When the resource version last changed",
      "type": [ {
        "code": "instant"
      } ],
      "mustSupport": true,
      "max": "1",
      "id": "Practitioner.meta.lastUpdated",
      "comment": "Defines the date the Resource was created or updated, whichever comes last (163).  Payers SHALL provide the last time the data was updated or the date of creation in the payer’s system of record, whichever comes last. Apps will use the meta.lastUpdated value to determine if the Reference resources are as of the current date or date of service.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Meta.lastUpdated"
      },
      "isSummary": true
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "source": "http://hl7.org/fhir/StructureDefinition/Element",
        "severity": "error",
        "expression": "hasValue() or (children().count() > id.count())"
      } ],
      "path": "Practitioner.meta.source",
      "min": 0,
      "definition": "A uri that identifies the source system of the resource. This provides a minimal amount of [Provenance](http://hl7.org/fhir/R4/provenance.html#) information that can be used to track or differentiate the source of information in the resource. The source may identify another FHIR server, document, message, database, etc.",
      "isModifier": false,
      "short": "Identifies where the resource comes from",
      "type": [ {
        "code": "uri"
      } ],
      "max": "1",
      "id": "Practitioner.meta.source",
      "comment": "In the provenance resource, this corresponds to Provenance.entity.what[x]. The exact use of the source (and the implied Provenance.entity.role) is left to implementer discretion. Only one nominated source is allowed; for additional provenance details, a full Provenance resource should be used. \n\nThis element can be used to indicate where the current master source of a resource that has a canonical URL if the resource is no longer hosted at the canonical URL.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Meta.source"
      },
      "isSummary": true
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "source": "http://hl7.org/fhir/StructureDefinition/Element",
        "severity": "error",
        "expression": "hasValue() or (children().count() > id.count())"
      } ],
      "path": "Practitioner.meta.profile",
      "min": 1,
      "definition": "A list of profiles (references to [StructureDefinition](http://hl7.org/fhir/R4/structuredefinition.html#) resources) that this resource claims to conform to. The URL is a reference to [StructureDefinition.url](http://hl7.org/fhir/R4/structuredefinition-definitions.html#StructureDefinition.url).",
      "isModifier": false,
      "short": "Profiles this resource claims to conform to",
      "type": [ {
        "code": "canonical",
        "targetProfile": [ "http://hl7.org/fhir/StructureDefinition/StructureDefinition" ]
      } ],
      "mustSupport": true,
      "max": "*",
      "id": "Practitioner.meta.profile",
      "comment": "CPCDS data element (190)",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Meta.profile"
      },
      "isSummary": true
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "source": "http://hl7.org/fhir/StructureDefinition/Element",
        "severity": "error",
        "expression": "hasValue() or (children().count() > id.count())"
      } ],
      "path": "Practitioner.meta.security",
      "min": 0,
      "definition": "Security labels applied to this resource. These tags connect specific resources to the overall security policy and infrastructure.",
      "isModifier": false,
      "short": "Security Labels applied to this resource",
      "type": [ {
        "code": "Coding"
      } ],
      "binding": {
        "strength": "extensible",
        "valueSet": "http://hl7.org/fhir/ValueSet/security-labels",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString": "SecurityLabels"
        }, {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
          "valueBoolean": true
        } ],
        "description": "Security Labels from the Healthcare Privacy and Security Classification System."
      },
      "max": "*",
      "id": "Practitioner.meta.security",
      "comment": "The security labels can be updated without changing the stated version of the resource. The list of security labels is a set. Uniqueness is based the system/code, and version and display are ignored.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Meta.security"
      },
      "isSummary": true
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "source": "http://hl7.org/fhir/StructureDefinition/Element",
        "severity": "error",
        "expression": "hasValue() or (children().count() > id.count())"
      } ],
      "path": "Practitioner.meta.tag",
      "min": 0,
      "definition": "Tags applied to this resource. Tags are intended to be used to identify and relate resources to process and workflow, and applications are not required to consider the tags when interpreting the meaning of a resource.",
      "isModifier": false,
      "short": "Tags applied to this resource",
      "type": [ {
        "code": "Coding"
      } ],
      "binding": {
        "strength": "example",
        "valueSet": "http://hl7.org/fhir/ValueSet/common-tags",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString": "Tags"
        } ],
        "description": "Codes that represent various types of tags, commonly workflow-related; e.g. \"Needs review by Dr. Jones\"."
      },
      "max": "*",
      "id": "Practitioner.meta.tag",
      "comment": "The tags can be updated without changing the stated version of the resource. The list of tags is a set. Uniqueness is based the system/code, and version and display are ignored.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Meta.tag"
      },
      "isSummary": true
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "source": "http://hl7.org/fhir/StructureDefinition/Element",
        "severity": "error",
        "expression": "hasValue() or (children().count() > id.count())"
      } ],
      "path": "Practitioner.implicitRules",
      "min": 0,
      "definition": "A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.",
      "isModifier": true,
      "short": "A set of rules under which this content was created",
      "type": [ {
        "code": "uri"
      } ],
      "max": "1",
      "id": "Practitioner.implicitRules",
      "comment": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Resource.implicitRules"
      },
      "isModifierReason": "This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation",
      "isSummary": true
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "source": "http://hl7.org/fhir/StructureDefinition/Element",
        "severity": "error",
        "expression": "hasValue() or (children().count() > id.count())"
      } ],
      "path": "Practitioner.language",
      "min": 0,
      "definition": "The base language in which the resource is written.",
      "isModifier": false,
      "short": "Language of the resource content",
      "type": [ {
        "code": "code"
      } ],
      "binding": {
        "strength": "preferred",
        "valueSet": "http://hl7.org/fhir/ValueSet/languages",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-maxValueSet",
          "valueCanonical": "http://hl7.org/fhir/ValueSet/all-languages"
        }, {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString": "Language"
        }, {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
          "valueBoolean": true
        } ],
        "description": "A human language."
      },
      "max": "1",
      "id": "Practitioner.language",
      "comment": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Resource.language"
      },
      "isSummary": false
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "source": "http://hl7.org/fhir/StructureDefinition/Element",
        "severity": "error",
        "expression": "hasValue() or (children().count() > id.count())"
      } ],
      "path": "Practitioner.text",
      "min": 0,
      "definition": "A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it \"clinically safe\" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.",
      "isModifier": false,
      "short": "Text summary of the resource, for human interpretation",
      "mapping": [ {
        "map": "Act.text?",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "Narrative"
      } ],
      "alias": [ "narrative", "html", "xhtml", "display" ],
      "max": "1",
      "id": "Practitioner.text",
      "comment": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded information is added later.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "DomainResource.text"
      },
      "isSummary": false
    }, {
      "path": "Practitioner.contained",
      "min": 0,
      "definition": "These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.",
      "isModifier": false,
      "short": "Contained, inline Resources",
      "mapping": [ {
        "map": "N/A",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "Resource"
      } ],
      "alias": [ "inline resources", "anonymous resources", "contained resources" ],
      "max": "*",
      "id": "Practitioner.contained",
      "comment": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "DomainResource.contained"
      },
      "isSummary": false
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "source": "http://hl7.org/fhir/StructureDefinition/Element",
        "severity": "error",
        "expression": "hasValue() or (children().count() > id.count())"
      }, {
        "key": "ext-1",
        "human": "Must have either extensions or value[x], not both",
        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
        "source": "http://hl7.org/fhir/StructureDefinition/Extension",
        "severity": "error",
        "expression": "extension.exists() != value.exists()"
      } ],
      "path": "Practitioner.extension",
      "min": 0,
      "definition": "May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
      "isModifier": false,
      "short": "Additional content defined by implementations",
      "mapping": [ {
        "map": "N/A",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "Extension"
      } ],
      "alias": [ "extensions", "user content" ],
      "max": "*",
      "id": "Practitioner.extension",
      "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "DomainResource.extension"
      },
      "isSummary": false
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "source": "http://hl7.org/fhir/StructureDefinition/Element",
        "severity": "error",
        "expression": "hasValue() or (children().count() > id.count())"
      }, {
        "key": "ext-1",
        "human": "Must have either extensions or value[x], not both",
        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
        "source": "http://hl7.org/fhir/StructureDefinition/Extension",
        "severity": "error",
        "expression": "extension.exists() != value.exists()"
      } ],
      "path": "Practitioner.modifierExtension",
      "requirements": "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).",
      "min": 0,
      "definition": "May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
      "isModifier": true,
      "short": "Extensions that cannot be ignored",
      "mapping": [ {
        "map": "N/A",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "Extension"
      } ],
      "alias": [ "extensions", "user content" ],
      "max": "*",
      "id": "Practitioner.modifierExtension",
      "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "DomainResource.modifierExtension"
      },
      "isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them",
      "isSummary": false
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "source": "http://hl7.org/fhir/StructureDefinition/Element",
        "severity": "error",
        "expression": "hasValue() or (children().count() > id.count())"
      } ],
      "path": "Practitioner.identifier",
      "requirements": "Often, specific identities are assigned for the agent.",
      "min": 1,
      "definition": "An identifier that applies to this person in this role.",
      "isModifier": false,
      "short": "An identifier for the person as this agent",
      "mapping": [ {
        "map": "FiveWs.identifier",
        "identity": "w5"
      }, {
        "map": "PRD-7 (or XCN.1)",
        "identity": "v2"
      }, {
        "map": "./id",
        "identity": "rim"
      }, {
        "map": "./Identifiers",
        "identity": "servd"
      } ],
      "slicing": {
        "rules": "open",
        "discriminator": [ {
          "path": "$this",
          "type": "pattern"
        } ]
      },
      "type": [ {
        "code": "Identifier"
      } ],
      "mustSupport": true,
      "max": "*",
      "id": "Practitioner.identifier",
      "comment": "NPI must be supported as the identifier system in the US, Tax id is allowed, Local id is allowed in addition to an another identifier supplied by a jurisdictional authority such as a practitioner's *Drug Enforcement Administration (DEA)* number.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Practitioner.identifier"
      },
      "isSummary": true
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "source": "http://hl7.org/fhir/StructureDefinition/Element",
        "severity": "error",
        "expression": "hasValue() or (children().count() > id.count())"
      } ],
      "path": "Practitioner.identifier",
      "requirements": "Often, specific identities are assigned for the agent.",
      "min": 0,
      "definition": "An identifier that applies to this person in this role.",
      "isModifier": false,
      "short": "An identifier for the person as this agent",
      "mapping": [ {
        "map": "FiveWs.identifier",
        "identity": "w5"
      }, {
        "map": "PRD-7 (or XCN.1)",
        "identity": "v2"
      }, {
        "map": "./id",
        "identity": "rim"
      }, {
        "map": "./Identifiers",
        "identity": "servd"
      } ],
      "type": [ {
        "code": "Identifier"
      } ],
      "mustSupport": true,
      "sliceName": "NPI",
      "patternIdentifier": {
        "type": {
          "coding": [ {
            "code": "npi",
            "system": "http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBIdentifierType"
          } ]
        },
        "system": "http://hl7.org/fhir/sid/us-npi"
      },
      "max": "1",
      "id": "Practitioner.identifier:NPI",
      "comment": "The National Provider Identifier assigned to the Performing Provider. This is the lowest level of provider available (for example, if both individual and group are available, then the individual should be provided) (95).  Either the Tax Id or an NPI must be provided",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Practitioner.identifier"
      },
      "isSummary": true
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "source": "http://hl7.org/fhir/StructureDefinition/Element",
        "severity": "error",
        "expression": "hasValue() or (children().count() > id.count())"
      } ],
      "path": "Practitioner.identifier",
      "requirements": "Often, specific identities are assigned for the agent.",
      "min": 0,
      "definition": "An identifier that applies to this person in this role.",
      "isModifier": false,
      "short": "An identifier for the person as this agent",
      "mapping": [ {
        "map": "FiveWs.identifier",
        "identity": "w5"
      }, {
        "map": "PRD-7 (or XCN.1)",
        "identity": "v2"
      }, {
        "map": "./id",
        "identity": "rim"
      }, {
        "map": "./Identifiers",
        "identity": "servd"
      } ],
      "type": [ {
        "code": "Identifier"
      } ],
      "mustSupport": true,
      "sliceName": "tax",
      "patternIdentifier": {
        "type": {
          "coding": [ {
            "code": "TAX",
            "system": "http://terminology.hl7.org/CodeSystem/v2-0203"
          } ]
        },
        "system": "urn:oid:2.16.840.1.113883.4.4"
      },
      "max": "*",
      "id": "Practitioner.identifier:tax",
      "comment": "Tax ID Number.  Either the Tax Id or an NPI must be provided",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Practitioner.identifier"
      },
      "isSummary": true
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "source": "http://hl7.org/fhir/StructureDefinition/Element",
        "severity": "error",
        "expression": "hasValue() or (children().count() > id.count())"
      } ],
      "path": "Practitioner.active",
      "requirements": "Need to be able to mark a practitioner record as not to be used because it was created in error.",
      "min": 0,
      "definition": "Whether this practitioner's record is in active use.",
      "isModifier": false,
      "short": "Whether this practitioner's record is in active use",
      "mapping": [ {
        "map": "FiveWs.status",
        "identity": "w5"
      }, {
        "map": "./statusCode",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "boolean"
      } ],
      "meaningWhenMissing": "This resource is generally assumed to be active if no value is provided for the active element",
      "max": "1",
      "id": "Practitioner.active",
      "comment": "If the practitioner is not in use by one organization, then it should mark the period on the PractitonerRole with an end date (even if they are active) as they may be active in another role.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Practitioner.active"
      },
      "isSummary": true
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "source": "http://hl7.org/fhir/StructureDefinition/Element",
        "severity": "error",
        "expression": "hasValue() or (children().count() > id.count())"
      } ],
      "path": "Practitioner.name",
      "requirements": "The name(s) that a Practitioner is known by. Where there are multiple, the name that the practitioner is usually known as should be used in the display.",
      "min": 1,
      "definition": "The name(s) associated with the practitioner.",
      "isModifier": false,
      "short": "The name(s) associated with the practitioner",
      "mapping": [ {
        "map": "XCN Components",
        "identity": "v2"
      }, {
        "map": "./name",
        "identity": "rim"
      }, {
        "map": "./PreferredName (GivenNames, FamilyName, TitleCode)",
        "identity": "servd"
      } ],
      "type": [ {
        "code": "HumanName"
      } ],
      "mustSupport": true,
      "max": "*",
      "id": "Practitioner.name",
      "comment": "The name of the Performing Provider. This is the lowest level of provider available (for example, if both individual and group are available, then the individual should be provided) (168)",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Practitioner.name"
      },
      "isSummary": true
    }, {
      "path": "Practitioner.name.id",
      "min": 0,
      "definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
      "isModifier": false,
      "short": "Unique id for inter-element referencing",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "http://hl7.org/fhirpath/System.String",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
          "valueUrl": "string"
        } ]
      } ],
      "representation": [ "xmlAttr" ],
      "max": "1",
      "id": "Practitioner.name.id",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Element.id"
      },
      "isSummary": false
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "source": "http://hl7.org/fhir/StructureDefinition/Element",
        "severity": "error",
        "expression": "hasValue() or (children().count() > id.count())"
      }, {
        "key": "ext-1",
        "human": "Must have either extensions or value[x], not both",
        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
        "source": "http://hl7.org/fhir/StructureDefinition/Extension",
        "severity": "error",
        "expression": "extension.exists() != value.exists()"
      } ],
      "path": "Practitioner.name.extension",
      "min": 0,
      "definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
      "isModifier": false,
      "short": "Additional content defined by implementations",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      } ],
      "slicing": {
        "rules": "open",
        "description": "Extensions are always sliced by (at least) url",
        "discriminator": [ {
          "path": "url",
          "type": "value"
        } ]
      },
      "type": [ {
        "code": "Extension"
      } ],
      "alias": [ "extensions", "user content" ],
      "max": "*",
      "id": "Practitioner.name.extension",
      "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Element.extension"
      },
      "isSummary": false
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "source": "http://hl7.org/fhir/StructureDefinition/Element",
        "severity": "error",
        "expression": "hasValue() or (children().count() > id.count())"
      } ],
      "path": "Practitioner.name.use",
      "requirements": "Allows the appropriate name for a particular context of use to be selected from among a set of names.",
      "min": 0,
      "definition": "Identifies the purpose for this name.",
      "isModifier": true,
      "short": "usual | official | temp | nickname | anonymous | old | maiden",
      "mapping": [ {
        "map": "XPN.7, but often indicated by which field contains the name",
        "identity": "v2"
      }, {
        "map": "unique(./use)",
        "identity": "rim"
      }, {
        "map": "./NamePurpose",
        "identity": "servd"
      } ],
      "type": [ {
        "code": "code"
      } ],
      "binding": {
        "strength": "required",
        "valueSet": "http://hl7.org/fhir/ValueSet/name-use|4.0.1",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString": "NameUse"
        } ],
        "description": "The use of a human name."
      },
      "max": "1",
      "id": "Practitioner.name.use",
      "comment": "Applications can assume that a name is current unless it explicitly says that it is temporary or old.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "HumanName.use"
      },
      "isModifierReason": "This is labeled as \"Is Modifier\" because applications should not mistake a temporary or old name etc.for a current/permanent one",
      "isSummary": true
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "source": "http://hl7.org/fhir/StructureDefinition/Element",
        "severity": "error",
        "expression": "hasValue() or (children().count() > id.count())"
      } ],
      "path": "Practitioner.name.text",
      "requirements": "A renderable, unencoded form.",
      "min": 0,
      "definition": "Specifies the entire name as it should be displayed e.g. on an application UI. This may be provided instead of or as well as the specific parts.",
      "isModifier": false,
      "short": "Text representation of the full name",
      "mapping": [ {
        "map": "implied by XPN.11",
        "identity": "v2"
      }, {
        "map": "./formatted",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "string"
      } ],
      "max": "1",
      "id": "Practitioner.name.text",
      "comment": "Can provide both a text representation and parts. Applications updating a name SHALL ensure that when both text and parts are present,  no content is included in the text that isn't found in a part.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "HumanName.text"
      },
      "isSummary": true
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "source": "http://hl7.org/fhir/StructureDefinition/Element",
        "severity": "error",
        "expression": "hasValue() or (children().count() > id.count())"
      } ],
      "path": "Practitioner.name.family",
      "min": 1,
      "definition": "The part of a name that links to the genealogy. In some cultures (e.g. Eritrea) the family name of a son is the first name of his father.",
      "isModifier": false,
      "short": "Family name (often called 'Surname')",
      "mapping": [ {
        "map": "XPN.1/FN.1",
        "identity": "v2"
      }, {
        "map": "./part[partType = FAM]",
        "identity": "rim"
      }, {
        "map": "./FamilyName",
        "identity": "servd"
      } ],
      "type": [ {
        "code": "string"
      } ],
      "mustSupport": true,
      "alias": [ "surname" ],
      "max": "1",
      "id": "Practitioner.name.family",
      "comment": "Family Name may be decomposed into specific parts using extensions (de, nl, es related cultures).",
      "base": {
        "max": "1",
        "min": 0,
        "path": "HumanName.family"
      },
      "isSummary": true
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "source": "http://hl7.org/fhir/StructureDefinition/Element",
        "severity": "error",
        "expression": "hasValue() or (children().count() > id.count())"
      } ],
      "path": "Practitioner.name.given",
      "min": 0,
      "definition": "Given name.",
      "isModifier": false,
      "short": "Given names (not always 'first'). Includes middle names",
      "mapping": [ {
        "map": "XPN.2 + XPN.3",
        "identity": "v2"
      }, {
        "map": "./part[partType = GIV]",
        "identity": "rim"
      }, {
        "map": "./GivenNames",
        "identity": "servd"
      } ],
      "type": [ {
        "code": "string"
      } ],
      "alias": [ "first name", "middle name" ],
      "max": "*",
      "id": "Practitioner.name.given",
      "comment": "If only initials are recorded, they may be used in place of the full name parts. Initials may be separated into multiple given names but often aren't due to paractical limitations.  This element is not called \"first name\" since given names do not always come first.",
      "orderMeaning": "Given Names appear in the correct order for presenting the name",
      "base": {
        "max": "*",
        "min": 0,
        "path": "HumanName.given"
      },
      "isSummary": true
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "source": "http://hl7.org/fhir/StructureDefinition/Element",
        "severity": "error",
        "expression": "hasValue() or (children().count() > id.count())"
      } ],
      "path": "Practitioner.name.prefix",
      "min": 0,
      "definition": "Part of the name that is acquired as a title due to academic, legal, employment or nobility status, etc. and that appears at the start of the name.",
      "isModifier": false,
      "short": "Parts that come before the name",
      "mapping": [ {
        "map": "XPN.5",
        "identity": "v2"
      }, {
        "map": "./part[partType = PFX]",
        "identity": "rim"
      }, {
        "map": "./TitleCode",
        "identity": "servd"
      } ],
      "type": [ {
        "code": "string"
      } ],
      "max": "*",
      "id": "Practitioner.name.prefix",
      "orderMeaning": "Prefixes appear in the correct order for presenting the name",
      "base": {
        "max": "*",
        "min": 0,
        "path": "HumanName.prefix"
      },
      "isSummary": true
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "source": "http://hl7.org/fhir/StructureDefinition/Element",
        "severity": "error",
        "expression": "hasValue() or (children().count() > id.count())"
      } ],
      "path": "Practitioner.name.suffix",
      "min": 0,
      "definition": "Part of the name that is acquired as a title due to academic, legal, employment or nobility status, etc. and that appears at the end of the name.",
      "isModifier": false,
      "short": "Parts that come after the name",
      "mapping": [ {
        "map": "XPN/4",
        "identity": "v2"
      }, {
        "map": "./part[partType = SFX]",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "string"
      } ],
      "max": "*",
      "id": "Practitioner.name.suffix",
      "orderMeaning": "Suffixes appear in the correct order for presenting the name",
      "base": {
        "max": "*",
        "min": 0,
        "path": "HumanName.suffix"
      },
      "isSummary": true
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "source": "http://hl7.org/fhir/StructureDefinition/Element",
        "severity": "error",
        "expression": "hasValue() or (children().count() > id.count())"
      } ],
      "path": "Practitioner.name.period",
      "requirements": "Allows names to be placed in historical context.",
      "min": 0,
      "definition": "Indicates the period of time when this name was valid for the named person.",
      "isModifier": false,
      "short": "Time period when name was/is in use",
      "mapping": [ {
        "map": "XPN.13 + XPN.14",
        "identity": "v2"
      }, {
        "map": "./usablePeriod[type=\"IVL\"]",
        "identity": "rim"
      }, {
        "map": "./StartDate and ./EndDate",
        "identity": "servd"
      } ],
      "type": [ {
        "code": "Period"
      } ],
      "max": "1",
      "id": "Practitioner.name.period",
      "base": {
        "max": "1",
        "min": 0,
        "path": "HumanName.period"
      },
      "isSummary": true
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "source": "http://hl7.org/fhir/StructureDefinition/Element",
        "severity": "error",
        "expression": "hasValue() or (children().count() > id.count())"
      } ],
      "path": "Practitioner.telecom",
      "requirements": "Need to know how to reach a practitioner independent to any roles the practitioner may have.",
      "min": 0,
      "definition": "A contact detail for the practitioner, e.g. a telephone number or an email address.",
      "isModifier": false,
      "short": "A contact detail for the practitioner (that apply to all roles)",
      "mapping": [ {
        "map": "PRT-15, STF-10, ROL-12",
        "identity": "v2"
      }, {
        "map": "./telecom",
        "identity": "rim"
      }, {
        "map": "./ContactPoints",
        "identity": "servd"
      } ],
      "type": [ {
        "code": "ContactPoint"
      } ],
      "max": "*",
      "id": "Practitioner.telecom",
      "comment": "Person may have multiple ways to be contacted with different uses or applicable periods.  May need to have options for contacting the person urgently and to help with identification.  These typically will have home numbers, or mobile numbers that are not role specific.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Practitioner.telecom"
      },
      "isSummary": true
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "source": "http://hl7.org/fhir/StructureDefinition/Element",
        "severity": "error",
        "expression": "hasValue() or (children().count() > id.count())"
      } ],
      "path": "Practitioner.address",
      "requirements": "The home/mailing address of the practitioner is often required for employee administration purposes, and also for some rostering services where the start point (practitioners home) can be used in calculations.",
      "min": 0,
      "definition": "Address(es) of the practitioner that are not role specific (typically home address). \rWork addresses are not typically entered in this property as they are usually role dependent.",
      "isModifier": false,
      "short": "Address(es) of the practitioner that are not role specific (typically home address)",
      "mapping": [ {
        "map": "ORC-24, STF-11, ROL-11, PRT-14",
        "identity": "v2"
      }, {
        "map": "./addr",
        "identity": "rim"
      }, {
        "map": "./Addresses",
        "identity": "servd"
      } ],
      "type": [ {
        "code": "Address"
      } ],
      "max": "*",
      "id": "Practitioner.address",
      "comment": "Address(es) of the practitioner",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Practitioner.address"
      },
      "isSummary": true
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "source": "http://hl7.org/fhir/StructureDefinition/Element",
        "severity": "error",
        "expression": "hasValue() or (children().count() > id.count())"
      } ],
      "path": "Practitioner.gender",
      "requirements": "Needed to address the person correctly.",
      "min": 0,
      "definition": "Administrative Gender - the gender that the person is considered to have for administration and record keeping purposes.",
      "isModifier": false,
      "short": "male | female | other | unknown",
      "mapping": [ {
        "map": "STF-5",
        "identity": "v2"
      }, {
        "map": "./administrativeGender",
        "identity": "rim"
      }, {
        "map": "./GenderCode",
        "identity": "servd"
      } ],
      "type": [ {
        "code": "code"
      } ],
      "binding": {
        "strength": "required",
        "valueSet": "http://hl7.org/fhir/ValueSet/administrative-gender|4.0.1",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString": "AdministrativeGender"
        }, {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
          "valueBoolean": true
        } ],
        "description": "The gender of a person used for administrative purposes."
      },
      "max": "1",
      "id": "Practitioner.gender",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Practitioner.gender"
      },
      "isSummary": true
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "source": "http://hl7.org/fhir/StructureDefinition/Element",
        "severity": "error",
        "expression": "hasValue() or (children().count() > id.count())"
      } ],
      "path": "Practitioner.birthDate",
      "requirements": "Needed for identification.",
      "min": 0,
      "definition": "The date of birth for the practitioner.",
      "isModifier": false,
      "short": "The date  on which the practitioner was born",
      "mapping": [ {
        "map": "STF-6",
        "identity": "v2"
      }, {
        "map": "./birthTime",
        "identity": "rim"
      }, {
        "map": "(not represented in ServD)",
        "identity": "servd"
      } ],
      "type": [ {
        "code": "date"
      } ],
      "max": "1",
      "id": "Practitioner.birthDate",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Practitioner.birthDate"
      },
      "isSummary": true
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "source": "http://hl7.org/fhir/StructureDefinition/Element",
        "severity": "error",
        "expression": "hasValue() or (children().count() > id.count())"
      } ],
      "path": "Practitioner.photo",
      "requirements": "Many EHR systems have the capability to capture an image of patients and personnel. Fits with newer social media usage too.",
      "min": 0,
      "definition": "Image of the person.",
      "isModifier": false,
      "short": "Image of the person",
      "mapping": [ {
        "map": "./subjectOf/ObservationEvent[code=\"photo\"]/value",
        "identity": "rim"
      }, {
        "map": "./ImageURI (only supports the URI reference)",
        "identity": "servd"
      } ],
      "type": [ {
        "code": "Attachment"
      } ],
      "max": "*",
      "id": "Practitioner.photo",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Practitioner.photo"
      },
      "isSummary": false
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "source": "http://hl7.org/fhir/StructureDefinition/Element",
        "severity": "error",
        "expression": "hasValue() or (children().count() > id.count())"
      } ],
      "path": "Practitioner.qualification",
      "min": 0,
      "definition": "The official certifications, training, and licenses that authorize or otherwise pertain to the provision of care by the practitioner.  For example, a medical license issued by a medical board authorizing the practitioner to practice medicine within a certian locality.",
      "isModifier": false,
      "short": "Certification, licenses, or training pertaining to the provision of care",
      "mapping": [ {
        "map": "CER?",
        "identity": "v2"
      }, {
        "map": ".playingEntity.playingRole[classCode=QUAL].code",
        "identity": "rim"
      }, {
        "map": "./Qualifications",
        "identity": "servd"
      } ],
      "type": [ {
        "code": "BackboneElement"
      } ],
      "max": "*",
      "id": "Practitioner.qualification",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Practitioner.qualification"
      },
      "isSummary": false
    }, {
      "path": "Practitioner.qualification.id",
      "min": 0,
      "definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
      "isModifier": false,
      "short": "Unique id for inter-element referencing",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "http://hl7.org/fhirpath/System.String",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
          "valueUrl": "string"
        } ]
      } ],
      "representation": [ "xmlAttr" ],
      "max": "1",
      "id": "Practitioner.qualification.id",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Element.id"
      },
      "isSummary": false
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "source": "http://hl7.org/fhir/StructureDefinition/Element",
        "severity": "error",
        "expression": "hasValue() or (children().count() > id.count())"
      }, {
        "key": "ext-1",
        "human": "Must have either extensions or value[x], not both",
        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
        "source": "http://hl7.org/fhir/StructureDefinition/Extension",
        "severity": "error",
        "expression": "extension.exists() != value.exists()"
      } ],
      "path": "Practitioner.qualification.extension",
      "min": 0,
      "definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
      "isModifier": false,
      "short": "Additional content defined by implementations",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "Extension"
      } ],
      "alias": [ "extensions", "user content" ],
      "max": "*",
      "id": "Practitioner.qualification.extension",
      "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Element.extension"
      },
      "isSummary": false
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "source": "http://hl7.org/fhir/StructureDefinition/Element",
        "severity": "error",
        "expression": "hasValue() or (children().count() > id.count())"
      }, {
        "key": "ext-1",
        "human": "Must have either extensions or value[x], not both",
        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
        "source": "http://hl7.org/fhir/StructureDefinition/Extension",
        "severity": "error",
        "expression": "extension.exists() != value.exists()"
      } ],
      "path": "Practitioner.qualification.modifierExtension",
      "requirements": "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).",
      "min": 0,
      "definition": "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
      "isModifier": true,
      "short": "Extensions that cannot be ignored even if unrecognized",
      "mapping": [ {
        "map": "N/A",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "Extension"
      } ],
      "alias": [ "extensions", "user content", "modifiers" ],
      "max": "*",
      "id": "Practitioner.qualification.modifierExtension",
      "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "BackboneElement.modifierExtension"
      },
      "isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
      "isSummary": true
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "source": "http://hl7.org/fhir/StructureDefinition/Element",
        "severity": "error",
        "expression": "hasValue() or (children().count() > id.count())"
      } ],
      "path": "Practitioner.qualification.identifier",
      "requirements": "Often, specific identities are assigned for the qualification.",
      "min": 0,
      "definition": "An identifier that applies to this person's qualification in this role.",
      "isModifier": false,
      "short": "An identifier for this qualification for the practitioner",
      "mapping": [ {
        "map": ".playingEntity.playingRole[classCode=QUAL].id",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "Identifier"
      } ],
      "max": "*",
      "id": "Practitioner.qualification.identifier",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Practitioner.qualification.identifier"
      },
      "isSummary": false
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "source": "http://hl7.org/fhir/StructureDefinition/Element",
        "severity": "error",
        "expression": "hasValue() or (children().count() > id.count())"
      } ],
      "path": "Practitioner.qualification.code",
      "min": 1,
      "definition": "Coded representation of the qualification.",
      "isModifier": false,
      "short": "Coded representation of the qualification",
      "mapping": [ {
        "map": ".playingEntity.playingRole[classCode=QUAL].code",
        "identity": "rim"
      }, {
        "map": "./Qualifications.Value",
        "identity": "servd"
      } ],
      "type": [ {
        "code": "CodeableConcept"
      } ],
      "binding": {
        "strength": "example",
        "valueSet": "http://terminology.hl7.org/ValueSet/v2-2.7-0360",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString": "Qualification"
        } ],
        "description": "Specific qualification the practitioner has to provide a service."
      },
      "max": "1",
      "id": "Practitioner.qualification.code",
      "base": {
        "max": "1",
        "min": 1,
        "path": "Practitioner.qualification.code"
      },
      "isSummary": false
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "source": "http://hl7.org/fhir/StructureDefinition/Element",
        "severity": "error",
        "expression": "hasValue() or (children().count() > id.count())"
      } ],
      "path": "Practitioner.qualification.period",
      "requirements": "Qualifications are often for a limited period of time, and can be revoked.",
      "min": 0,
      "definition": "Period during which the qualification is valid.",
      "isModifier": false,
      "short": "Period during which the qualification is valid",
      "mapping": [ {
        "map": ".playingEntity.playingRole[classCode=QUAL].effectiveTime",
        "identity": "rim"
      }, {
        "map": "./Qualifications.StartDate and ./Qualifications.EndDate",
        "identity": "servd"
      } ],
      "type": [ {
        "code": "Period"
      } ],
      "max": "1",
      "id": "Practitioner.qualification.period",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Practitioner.qualification.period"
      },
      "isSummary": false
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "source": "http://hl7.org/fhir/StructureDefinition/Element",
        "severity": "error",
        "expression": "hasValue() or (children().count() > id.count())"
      } ],
      "path": "Practitioner.qualification.issuer",
      "min": 0,
      "definition": "Organization that regulates and issues the qualification.",
      "isModifier": false,
      "short": "Organization that regulates and issues the qualification",
      "mapping": [ {
        "map": ".playingEntity.playingRole[classCode=QUAL].scoper",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "Reference",
        "targetProfile": [ "http://hl7.org/fhir/StructureDefinition/Organization" ]
      } ],
      "max": "1",
      "id": "Practitioner.qualification.issuer",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Practitioner.qualification.issuer"
      },
      "isSummary": false
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "source": "http://hl7.org/fhir/StructureDefinition/Element",
        "severity": "error",
        "expression": "hasValue() or (children().count() > id.count())"
      } ],
      "path": "Practitioner.communication",
      "requirements": "Knowing which language a practitioner speaks can help in facilitating communication with patients.",
      "min": 0,
      "definition": "A language the practitioner can use in patient communication.",
      "isModifier": false,
      "short": "A language the practitioner can use in patient communication",
      "mapping": [ {
        "map": "PID-15, NK1-20, LAN-2",
        "identity": "v2"
      }, {
        "map": "./languageCommunication",
        "identity": "rim"
      }, {
        "map": "./Languages.LanguageSpokenCode",
        "identity": "servd"
      } ],
      "type": [ {
        "code": "CodeableConcept"
      } ],
      "binding": {
        "strength": "preferred",
        "valueSet": "http://hl7.org/fhir/ValueSet/languages",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-maxValueSet",
          "valueCanonical": "http://hl7.org/fhir/ValueSet/all-languages"
        }, {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString": "Language"
        }, {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
          "valueBoolean": true
        } ],
        "description": "A human language."
      },
      "max": "*",
      "id": "Practitioner.communication",
      "comment": "The structure aa-BB with this exact casing is one the most widely used notations for locale. However not all systems code this but instead have it as free text. Hence CodeableConcept instead of code as the data type.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Practitioner.communication"
      },
      "isSummary": false
    } ]
  },
  "status": "active",
  "id": "9b5c5c67-864b-4791-80fa-ad2d2a6ad3c6",
  "kind": "resource",
  "url": "http://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-Practitioner",
  "version": "1.0.0",
  "differential": {
    "element": [ {
      "id": "Practitioner",
      "path": "Practitioner",
      "constraint": [ {
        "key": "dom-2",
        "human": "If the resource is contained in another resource, it SHALL NOT contain nested Resources",
        "xpath": "not(parent::f:contained and f:contained)",
        "source": "http://hl7.org/fhir/StructureDefinition/DomainResource",
        "severity": "error",
        "expression": "contained.contained.empty()"
      }, {
        "key": "dom-3",
        "human": "If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource",
        "xpath": "not(exists(for $id in f:contained/*/f:id/@value return $contained[not(parent::*/descendant::f:reference/@value=concat('#', $contained/*/id/@value) or descendant::f:reference[@value='#'])]))",
        "source": "http://hl7.org/fhir/StructureDefinition/DomainResource",
        "severity": "error",
        "expression": "contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()"
      }, {
        "key": "dom-4",
        "human": "If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated",
        "xpath": "not(exists(f:contained/*/f:meta/f:versionId)) and not(exists(f:contained/*/f:meta/f:lastUpdated))",
        "source": "http://hl7.org/fhir/StructureDefinition/DomainResource",
        "severity": "error",
        "expression": "contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()"
      }, {
        "key": "dom-5",
        "human": "If a resource is contained in another resource, it SHALL NOT have a security label",
        "xpath": "not(exists(f:contained/*/f:meta/f:security))",
        "source": "http://hl7.org/fhir/StructureDefinition/DomainResource",
        "severity": "error",
        "expression": "contained.meta.security.empty()"
      }, {
        "key": "dom-6",
        "human": "A resource should have narrative for robust management",
        "xpath": "exists(f:text/h:div)",
        "source": "http://hl7.org/fhir/StructureDefinition/DomainResource",
        "severity": "warning",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice",
          "valueBoolean": true
        }, {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice-explanation",
          "valueMarkdown": "When a resource has no narrative, only systems that fully understand the data can display the resource to a human safely. Including a human readable representation in the resource makes for a much more robust eco-system and cheaper handling of resources by intermediary systems. Some ecosystems restrict distribution of resources to only those systems that do fully understand the resources, and as a consequence implementers may believe that the narrative is superfluous. However experience shows that such eco-systems often open up to new participants over time."
        } ],
        "expression": "text.`div`.exists()"
      }, {
        "key": "Practitioner-identifier",
        "human": "Practitioner.identifier must include an NPI or a Tax ID",
        "source": "http://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-Practitioner",
        "severity": "error",
        "expression": "identifier.where(type.where(coding.where(code in ('npi' | 'TAX')).exists()).exists()).exists()"
      } ]
    }, {
      "id": "Practitioner.meta",
      "min": 1,
      "path": "Practitioner.meta",
      "mustSupport": true
    }, {
      "id": "Practitioner.meta.lastUpdated",
      "min": 1,
      "path": "Practitioner.meta.lastUpdated",
      "comment": "Defines the date the Resource was created or updated, whichever comes last (163).  Payers SHALL provide the last time the data was updated or the date of creation in the payer’s system of record, whichever comes last. Apps will use the meta.lastUpdated value to determine if the Reference resources are as of the current date or date of service.",
      "mustSupport": true
    }, {
      "id": "Practitioner.meta.profile",
      "min": 1,
      "path": "Practitioner.meta.profile",
      "comment": "CPCDS data element (190)",
      "mustSupport": true
    }, {
      "id": "Practitioner.identifier:NPI",
      "path": "Practitioner.identifier",
      "comment": "The National Provider Identifier assigned to the Performing Provider. This is the lowest level of provider available (for example, if both individual and group are available, then the individual should be provided) (95).  Either the Tax Id or an NPI must be provided",
      "sliceName": "NPI",
      "patternIdentifier": {
        "type": {
          "coding": [ {
            "code": "npi",
            "system": "http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBIdentifierType"
          } ]
        },
        "system": "http://hl7.org/fhir/sid/us-npi"
      }
    }, {
      "id": "Practitioner.identifier:tax",
      "max": "*",
      "min": 0,
      "path": "Practitioner.identifier",
      "comment": "Tax ID Number.  Either the Tax Id or an NPI must be provided",
      "sliceName": "tax",
      "patternIdentifier": {
        "type": {
          "coding": [ {
            "code": "TAX",
            "system": "http://terminology.hl7.org/CodeSystem/v2-0203"
          } ]
        },
        "system": "urn:oid:2.16.840.1.113883.4.4"
      }
    }, {
      "id": "Practitioner.name",
      "path": "Practitioner.name",
      "comment": "The name of the Performing Provider. This is the lowest level of provider available (for example, if both individual and group are available, then the individual should be provided) (168)"
    }, {
      "id": "Practitioner.address",
      "path": "Practitioner.address",
      "comment": "Address(es) of the practitioner"
    } ]
  },
  "contact": [ {
    "name": "HL7 Financial Management Working Group",
    "telecom": [ {
      "value": "http://www.hl7.org/Special/committees/fm/index.cfm",
      "system": "url"
    }, {
      "value": "fm@lists.HL7.org",
      "system": "email"
    } ]
  } ],
  "baseDefinition": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitioner"
}