Code
|
Provider
|
Prm Prov Flg
|
Wl Flg
|
Status
|
Definition
|
00 |
MD |
Y |
Y |
Active |
A doctor of medicine who, by virtue of education, training, and demonstrated competence, is granted clinical privileges by the organization to perform specific diagnostic or therapeutic procedure(s) and who is fully licensed to practice medicine. |
01 |
CLINIC RN |
N |
Y |
Active |
An individual who is qualified by an approved postsecondary program or baccalaureate or higher degree in nursing and licensed by the state, commonwealth, or territory to practice professional nursing. |
02 |
ENVIRONMENTAL HEALTH |
N |
Y |
Active |
An individual who focuses on the preservation and improvement of environmental factors affecting the health and safety of the community. |
03 |
HEALTH AIDE |
N |
Y |
Active |
An individual who performs under the general supervision of a nurse and assists in providing health services and first aid. |
04 |
HEALTH EDUCATOR |
N |
Y |
Active |
An individual who plans and conducts special and continuing health education programs and services. |
05 |
LICENSED PRACTICAL NURSE |
N |
Y |
Active |
A nurse who has completed a practical nursing program and is licensed by a state to provide routine patient care under the direction of a registered nurse or a physician. |
06 |
MEDICAL SOCIAL WORKER |
N |
Y |
Active |
An individual who performs casework with individuals and/or families to assist in the acceptance and management of social, emotional, health, and economic problems |
07 |
NUTRITIONIST |
N |
Y |
Active |
An individual who is an expert in the nutritional requirements of patients. Also called a dietitian. |
08 |
OPTOMETRIST |
N |
Y |
Active |
An individual who is a specialist in optometry. The profession of examining the eyes and measuring errors in refraction and of prescribing glasses to correct the defects. |
09 |
PHARMACIST |
N |
Y |
Active |
An individual who has a degree in pharmacy and is licensed and registered to prepare, preserve, compound, and dispense drugs and chemicals. [This code should be used for all pharmacist-patient visits not meeting the provider code 30 or 67 definition.] |
10 |
PHYSICAL THERAPIST |
N |
Y |
Active |
An individual who is a graduate of a physical therapist education program accredited by a nationally recognized accrediting body who meets any current legal requirements of licensure or registration or who has the documented equivalence in training, education, and experience and is currently competent in the field. Physical therapists assess, evaluate, and treat movement dysfunction and pain resulting from injury, disease, disability, or other health-related conditions. |
11 |
PHYSICIAN ASSISTANT |
Y |
Y |
Active |
An individual health care professional licensed to practice medicine with physician supervision. |
12 |
PSYCHOLOGIST |
N |
Y |
Active |
An individual who specializes in psychological research, testing, or therapy; deals with the emotional and mental processes, consciousness, sensation, ideation, and memory. |
13 |
PUBLIC HEALTH NURSE |
N |
Y |
Active |
An individual who practices in promoting and protecting the health of populations using knowledge from nursing, social, and public health sciences. |
14 |
SCHOOL NURSE |
N |
Y |
Active |
An individual who is either a Registered Nurse (RN) or a Licensed Practical Nurse (LPN) who is identified as a school nurse. |
15 |
OTHER |
N |
Y |
Active |
To be used for those providers that do not fit into any of the existing provider code definitions; TEMPORARY USE ONLY, until a provider code is requested/assigned. |
16 |
PEDIATRIC NURSE PRACTITIONER |
Y |
Y |
Active |
A registered nurse with advanced education/training; whose role is designed to meet the specialized physiologic and psychological needs of children with complex acute, critical and chronic health conditions. |
17 |
NURSE MIDWIFE |
Y |
Y |
Active |
A registered nurse who has received specialized training as a midwife who practices in the independent management of women’s health care, focusing particularly on pregnancy, childbirth, the postpartum period, care of the newborn, and the family planning and gynecological needs of women. |
18 |
CONTRACT PHYSICIAN |
Y |
Y |
Active |
See definition for MD – 00 |
19 |
MENTAL HEALTH TECHNICIAN |
N |
Y |
Active |
An individual with a high school diploma with some formal training in the mental health field, who works under the direct supervision of a licensed mental health specialist. |
20 |
MEDICAL STUDENT |
N |
Y |
Active |
A physician-in-training dedicated to learning the art and science of medicine. |
21 |
NURSE PRACTITIONER |
Y |
Y |
Active |
A registered nurse with advanced education/training who has acquired the expert knowledge base, complex decision-making skills and clinical competencies for expanded practice, the characteristics of which are shaped by the context in which s/he is credentialed to practice. |
22 |
NURSE ASSISTANT |
N |
Y |
Active |
An individual who assists in the provision of nursing or nursing related services under the direction of a registered nurse. |
23 |
LABORATORY TECHNICIAN |
N |
Y |
Active |
An individual who performs technical work in clinical [medical] laboratories performing tests and examinations in one or more areas of work such as chemistry, blood banking, hematology, or microbiology to assist in the diagnoses, treatment, and prevention of disease. |
24 |
CONTRACT OPTOMETRIST |
N |
Y |
Active |
See definition for Optometrist – 08 |
148 Record(s)
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