ISO/TS 27527:2010

Health informatics - Provider identification

ISO/TS 27527:2010 provides a framework for improving the positive identification of providers. Identification of "providers" encompasses individuals and organizations. ISO/TS 27527:2010 includes data elements needed for identification of individual providers (i.e. individuals) and data elements needed for the identification of organization providers (i.e. organizations). "Identification" in ISO/TS 27527:2010 refers both to the process of being able to identify individuals and organizations, and the data elements required to support that identification manually and from a computer processing perspective. ISO/TS 27527:2010 can be applied to all providers of services, individuals and organizations. It details both data and processes for collection and application of identifying information for providers. It defines demographic and other identifying data elements suited to capture and use for the identification of providers in health care settings and provides guidance on their application. ISO/TS 27527:2010 provides: definitions of data elements to support the identification of individual providers and organizational providers for purposes such as electronic health record authentication and authorization, communications, role definitions, delegation of authority, and the management of certification of individuals where more than one discipline is concerned; guidance on the development, population, governance and ongoing management of provider identifiers from multiple potential sources. This includes identification of processes to support national, multinational and provincial/state or local level identification. Unique identifier structures may differ for different purposes, or with different originating organizations. For this reason, a generic approach to the structure of these identifiers is given in ISO/TS 27527:2010 to support multiple unique identifiers and the ability to link these to the relevant provider. Annex A provides information to support the process of identification and implementation of provider identification in health care information systems. ISO/TS 27527:2010 is primarily concerned with provider identification data for clinical and administrative purposes. ISO/TS 27527:2010 is intended for use by health and health-related establishments that create, use or maintain records on providers. Establishments are intended to use ISO/TS 27527:2010, where appropriate, for collecting data when registering providers. ISO/TS 27527:2010 does not include the process for development of unique identifiers. Standards for the development of identifiers are provided in ISO/TS 22220. Data required to meet identification purposes is highly dependent upon the place and purpose of identification. ISO/TS 27527:2010 identifies a range of data that support the identification of an individual or organization used in different health care environments. ISO/TS 27527:2010 does not attempt to identify all the use cases for which the items included are relevant; however, the data elements are provided to allow their consistent representation where they are found appropriate to support identification activities of the organization or jurisdiction.

Informatique de santé — Identification du fournisseur

General Information

• Status: Published
• Publication Date: 19-Jul-2010
• ICS: 35.240.80 - IT applications in health care technology
• Technical Committee: ISO/TC 215 - Health informatics
• Drafting Committee: ISO/TC 215/WG 1 - Architecture, Frameworks and Models
• Current Stage: 9092 - International Standard to be revised
• Start Date: 17-Apr-2025
• Completion Date: 13-Dec-2025

Overview

ISO/TS 27527:2010 - Health informatics: Provider identification - defines a practical framework for the positive identification of healthcare providers, covering both individuals and organizations. The Technical Specification describes the data elements and processes needed to collect, store, govern and use provider identification data for clinical and administrative purposes. It supports consistent representation of provider identifiers and linking of multiple unique identifiers across national, multinational and local contexts. Annex A offers implementation guidance; the specification deliberately does not define how to create unique identifier schemes (see related standards).

Key topics and requirements

• Provider identifier structure: a generic model to represent multiple unique identifiers, including designation, geographic area, issuer and usage.
• Individual provider data: name components, demographic details, field of practice and other identity attributes needed for unambiguous identification.
• Organizational provider identification: data elements and processes to identify provider organizations and their relationships to sites and services.
• Biometric identifiers: support for biometric data where applicable to strengthen positive identification.
• Address and communications: standardized capture of provider addresses and electronic communication details (telephone, email, etc.).
• Governance and management: guidance on development, population, ongoing governance, duplicate resolution and linking of identifiers from multiple sources.
• Operational considerations: data capture at registration, authentication/authorization support for EHRs, delegation of authority and certification management where multiple disciplines are involved.
• Scope limitations: does not specify identifier generation rules - ISO/TS 22220 addresses identifier development; standards for message-level communication of identifiers are outside the scope (see HL7 standards).

Practical applications

ISO/TS 27527:2010 is designed to improve safety, interoperability and administrative efficiency by enabling:

• Reliable EHR authentication and authorization and audit trails.
• Accurate referrals, orders and results routing between providers.
• Consistent provider registries and directories supporting care continuity.
• Correct payments, reporting and workforce planning through unambiguous provider attribution.
• Support for quality reviews, research and regulatory reporting by ensuring records map to the correct provider.

Who should use this standard

• Health and health-related establishments that create, use or maintain provider records (hospitals, clinics, registries).
• EHR and health IT vendors implementing provider identity models.
• National/regional health authorities and credentialing bodies designing provider registries.
• Interoperability architects, privacy/security officers and clinical informaticians.

Related standards

• ISO/TS 22220 - Standards for development of unique identifiers (identifier generation and semantics).
• HL7 messaging standards - for communication of identifying information between systems.

Keywords: ISO/TS 27527:2010, provider identification, health informatics standard, provider identifier, healthcare provider data, EHR authentication, provider registry, unique identifier, provider demographics.

Standards Content (Sample)

TECHNICAL ISO/TS
SPECIFICATION 27527
First edition
2010-08-01
Health informatics — Provider
identification
Informatique de santé — Identification du fournisseur

Reference number
©
ISO 2010
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Contents Page
Foreword .v
Introduction.vi
1 Scope.1
2 Normative references.2
3 Terms and definitions .2
4 Components.3
4.1 Components introduction.3
4.2 Data element structure.5
4.3 Summary of provider identifiers .7
5 Provider identifier.9
5.1 Provider identifier introduction.9
5.2 Provider identifier designation .9
5.3 Provider identifier geographic area.10
5.4 Individual or organizational provider flag.11
5.5 Provider identifier issuer .11
5.6 Provider identifier usage .12
5.7 Duplicate resolution .12
6 Individual provider .14
6.1 Individual provider introduction .14
6.2 Individual provider name.15
6.3 Individual provider demographic details .22
6.4 Field of practice .25
7 Biometric identifiers.37
8 Provider organization identification .38
8.1 General .38
9 Provider address .47
9.1 General .47
9.2 Address line .49
9.3 Suburb/town/locality .50
9.4 State / territory / province identifier.50
9.5 Postal code .50
9.6 Delivery point identifier.50
9.7 Country identifier.50
9.8 Address type.50
9.9 Address type start date.50
9.10 Address type start date accuracy indicator.51
9.11 Address type end date.51
9.12 Address type end date accuracy indicator.51
9.13 Address security .51
9.14 Address available to provider .51
10 Provider electronic communications .51
10.1 General .51
10.2 Electronic communication medium.52
10.3 Electronic communication usage code.52
10.4 Electronic communication details .52
10.5 Communication privacy.52
10.6 Communication available to provider .53
Annex A (informative) Implementation.54
Bibliography .75

iv © ISO 2010 – All rights reserved

Foreword
ISO (the International Organization for Standardization) is a worldwide federation of national standards bodies
(ISO member bodies). The work of preparing International Standards is normally carried out through ISO
technical committees. Each member body interested in a subject for which a technical committee has been
established has the right to be represented on that committee. International organizations, governmental and
non-governmental, in liaison with ISO, also take part in the work. ISO collaborates closely with the
International Electrotechnical Commission (IEC) on all matters of electrotechnical standardization.
International Standards are drafted in accordance with the rules given in the ISO/IEC Directives, Part 2.
The main task of technical committees is to prepare International Standards. Draft International Standards
adopted by the technical committees are circulated to the member bodies for voting. Publication as an
International Standard requires approval by at least 75 % of the member bodies casting a vote.
In other circumstances, particularly when there is an urgent market requirement for such documents, a
technical committee may decide to publish other types of document:
— an ISO Publicly Available Specification (ISO/PAS) represents an agreement between technical experts in
an ISO working group and is accepted for publication if it is approved by more than 50 % of the members
of the parent committee casting a vote;
— an ISO Technical Specification (ISO/TS) represents an agreement between the members of a technical
committee and is accepted for publication if it is approved by 2/3 of the members of the committee casting
a vote.
An ISO/PAS or ISO/TS is reviewed after three years in order to decide whether it will be confirmed for a
further three years, revised to become an International Standard, or withdrawn. If the ISO/PAS or ISO/TS is
confirmed, it is reviewed again after a further three years, at which time it must either be transformed into an
International Standard or be withdrawn.
Attention is drawn to the possibility that some of the elements of this document may be the subject of patent
rights. ISO shall not be held responsible for identifying any or all such patent rights.
ISO/TS 27527 was prepared by Technical Committee ISO/TC 215, Health informatics.
Introduction
The ability to positively identify providers and locate their relevant details is an important support to the
provision of speedy, safe, high quality, comprehensive and efficient health care.
This Technical Specification is the result of health industry needs for a common, best practice approach to the
way data are used, captured, stored and managed for the purpose of identifying providers. The objective is to
provide the health industry with a Technical Specification for health care provider identification for clinical and
administrative data management purposes (data structure and specification) which promotes uniformly good
practice in identifying individual providers and providers as organizations and recording identifying data. This
will assist significantly in ensuring that records relating to each provider will be associated with that individual
or organization and no other.
Without such a document, the unique identification of providers will be jeopardized and there is a risk that
different parties may develop inconsistent methods.
This Technical Specification has important uses in common with ISO/TS 22220. For example, when patient
health information is shared between various providers for purposes of clinical management, it is advisable
that ISO/TS 22220 be used to ensure the unique identification of the patient associated with a particular
provider and organization.
In this initial publication, the scope of the Technical Specification has been limited to provider identification
and though it identifies the relationships required between providers, provider organizations, sites of services
and the services themselves, these are not discussed in detail.
This Technical Specification does not supersede any other International Standard or Technical Specification
but rather acts as a consolidation of best practice principles and guidelines for collection and storage of
provider identification data.
The term “informative” has been used in this Technical Specification to define the application of the annexes
applied to it. An informative annex is only for information and guidance. Safe and efficient patient care
requires that all organizations implementing shared access to electronic health records ensure that providers
of services are correctly and unambiguously identified, even if the records with which they are associated
come from sources outside conventional juridicational or organizational boundaries. This is critically important
to countries, provinces and/or states with significant cross-border flow of patients. This identification is further
complicated when one entity is certified by more than one professional organization or discipline, or works in
more than one organizational context. The provision of directories or lists of providers and their service
locations for consumer information and to support electronic communication between providers is beyond the
scope of this Technical Specification.
The ability to positively identify providers (both face-to-face and electronically) and to locate their relevant details,
is an important support to the provision of speedy, safe, high quality, comprehensive and efficient health care.
Unambiguous identification of providers (individuals or organizations) is necessary for a wide range of
purposes, including:
a) registration of providers;
b) requesting and/or reporting of orders, tests and results (e.g. pathology, diagnostic imaging);
c) other communications and referrals between providers regarding ongoing care of patients (e.g. a referral
from a general practitioner to a specialist, a hospital discharge plan);
d) reporting on health services provision to statutory authorities (e.g. reporting of hospital patient
administration systems data to state/territory government health agencies);
vi © ISO 2010 – All rights reserved

e) payments to providers; and
f) directories or lists of providers and their service locations for consumer information.
Benefits of positive identification include:
⎯ the ability to verify information about individual providers with other data to identify or confirm their
capabilities and qualifications (e.g. their speciality, registration with accredited bodies);
⎯ the ability to confidently communicate with other providers for ongoing client care;
⎯ the ability to compile reliable information about services provided by individual providers to individual clients;
⎯ efficient and appropriate payments of fees, rebates, etc., to providers;
⎯ reduction of the time wasted and inconvenience generated in searching for and/or re-gathering
information;
⎯ provision of a source of reliable information to access, authorization and security systems and enhances
provider and consumer confidence in electronic health records;
⎯ improvement of care quality by supporting professional practice reviews, research on care delivery
patterns and outcomes, etc.;
⎯ auditing who has added, changed or accessed electronic records for quality, access and privacy audits;
⎯ secondary use of provider data for purposes such as manpower planning and resource allocation.
Standards for the communication of identifying information are beyond the scope of this Technical
Specification, and are specified within standards of the Health Level 7 (HL7) organization.
The development and use of provider identification in health care supports collection and maintenance of
information, identifying the qualifications and accreditation of providers as well as electronic signature
information. This Technical Specification defines qualification data requirements but not those required for
electronic signatures as these are defined elsewhere.
The effective and efficient identification of providers translates to more efficient and high quality care.
The delivery of health care services is undergoing paradigm change, brought about by changing consumer
expectations, technological advances, economic pressures, socio-demographic change and changes in the
patterns of health and ill health in communities.
These changes include:
a) a shift from institution-centred care to client-centred care, together with greater empowerment of
consumers;
b) greater emphasis on continuity of services in supporting quality and safety, health promotion and
maintenance;
c) more integrated services, in which organizational and administrative barriers are invisible to clients;
d) migration from paper-based to electronic media for transactions including orders, tests and results,
sharing of patient health information between various providers, and payments to providers.
These changes underline the need for more careful attention to the provision of unambiguous identification of
providers across all disciplines and settings, especially where multiple records or information systems are involved.
This Technical Specification provides a framework for improving confidence in the data being associated with
any given provider, and upon which clinical communication and data aggregation are based, are appropriate
and accurate.
TECHNICAL SPECIFICATION ISO/TS 27527:2010(E)

Health informatics — Provider identification
1 Scope
This Technical Specification provides a framework for improving the positive identification of providers.
Identification of “providers” encompasses individuals and organizations. This Technical Specification includes
data elements needed for identification of individual providers (i.e. individuals) and data elements needed for
the identification of organization providers (i.e. organizations). “Identification” in this Technical Specification
refers both to the process of being able to identify individuals and organizations, and the data elements
required to support that identification manually and from a computer processing perspective.
This Technical Specification can be applied to all providers of services, individuals and organizations. It details
both data and processes for collection and application of identifying information for providers. It defines
demographic and other identifying data elements suited to capture and use for the identification of providers in
health care settings and provides guidance on their application.
This Technical Specification provides:
⎯ definitions of data elements to support the identification of individual providers and organizational
providers for purposes such as electronic health record authentication and authorization, communications,
role definitions, delegation of authority, and the management of certification of individuals where more
than one discipline is concerned;
⎯ guidance on the development, population, governance and ongoing management of provider identifiers
from multiple potential sources. This includes identification of processes to support national, multinational
and provincial/state or local level identification. Unique identifier structures may differ for different
purposes, or with different originating organizations. For this reason, a generic approach to the structure
of these identifiers is given in this Technical Specification to support multiple unique identifiers and the
ability to link these to the relevant provider.
⎯ Annex A provides information to support the process of identification and implementation of provider
identification in health care information systems.
This Technical Specification is primarily concerned with provider identification data for clinical and
administrative purposes. This Technical Specification is intended for use by health and health-related
establishments that create, use or maintain records on providers. Establishments are intended to use this
Technical Specification, where appropriate, for collecting data when registering providers.
This Technical Specification does not include the process for development of unique identifiers. Standards for
the development of identifiers are provided in ISO/TS 22220.
Data required to meet identification purposes is highly dependent upon the place and purpose of identification.
This Technical Specification identifies a range of data that support the identification of an individual or
organization used in different health care environments.
EXAMPLE Some systems use a phone number to confirm that a call is coming from a bona fide location, specifically
when confirming or requesting a fax. The phone number in this case is used as an additional item of identification.
This Technical Specification does not attempt to identify all the use cases for which the items included are
relevant; however, the data elements are provided to allow their consistent representation where they are
found appropriate to support identification activities of the organization or jurisdiction.
2 Normative references
The following referenced documents are indispensable for the application of this document. For dated
references, only the edition cited applies. For undated references, the latest edition of the referenced
document (including any amendments) applies.
ISO/IEC 19785-1, Information technology — Common Biometric Exchange Formats Framework —
Part 1: Data element specification
ISO/TS 22220:2009, Health informatics — Identification of subjects of health care
3 Terms and definitions
For the purposes of this document, the following terms and definitions apply.
3.1
business entity
recognized formal business entity, such as a corporation or company
NOTE This entity holds details of the formal “owner” entity of the organization.
3.2
capture
deliberate action that results in the registration of a record in a record-keeping system
[ISO/TS 22220:2009, definition 3.1]
3.3
individual provider
〈health care〉 person who provides or is a potential provider of a health care service
NOTE An individual provider is an individual person and is not considered to be a group of providers. Not all health
care providers are recognized by professional bodies. It is for this reason that the term health care professional has not
been used to describe them. All health care professionals are providers, but not all providers are health care professionals.
3.4
information system
organized set of people, procedures and equipment that enable, for decision making with stated objectives,
the collection and storage of those data that describe an actual situation and its evolution, their processing
into information and the transmission of this information
[http://www.metaglossary.com/meanings/501967/]
3.5
organization
〈health care〉 group or business entity involved in the direct or indirect provision of health care services to an
individual or to a population
NOTE 1 Groups or subdivisions of an organization, such as departments, can also be considered as organizations
where there is a need to identify them.
NOTE 2 Effectively, a health care organization relies on the activity performed by health care professionals, employed,
contracting, or with temporary informal though functional relationships between them: within health care organizations, the
final effectors are health care professionals. A health care team is a kind of health care organization.
NOTE 3 A free-standing self employed solo practising health care professional is considered as the only member of
his/her own health care organization.
NOTE 4 Adapted from EN 13606-5.
2 © ISO 2010 – All rights reserved

3.6
provider
〈health care〉 person or organization who is involved in or associated with the delivery of health care to a
subject of care, or caring for the well-being of a subject of care
NOTE A provider in this context includes not only health care providers, but also those directly involved in the
provision of services to patients.
3.7
provider identifier
health care provider identifier
HCPI
〈health care〉 unique number or code issued for the purpose of uniquely identifying a health care provider
3.8
records
recorded information, in any form, including data in computer systems, created or received and maintained by
an organization or person in the transaction of business or the conduct of affairs and kept as evidence of such
activity
[ISO 22220:2009, definition 3.5]
3.9
registration
act of giving a record a unique identity in a record-keeping system
[ISO 22220:2009, definition 3.6]
3.10
service entity
services provided by an organization or which an organization is able, or licensed, to provide
3.11
storage
function of storing records for future retrieval and use
[ISO/TS 22220:2009, definition 3.7]
4 Components
4.1 Components introduction
This Technical Specification includes recommendations concerning the data elements most likely to affect the
quality and ability to achieve accurate identification of providers, particularly when identifying individuals
face-to-face or when communicating electronically. This Technical Specification also identifies the data
elements suited to identification in the broad delivery environment.
The scope of identification in the environment of national registers includes the elements in Figure 1.
Figure 1 — Typical components of provider registers
The scope of this work is limited to the areas included in more detail in Figure 2, individual and organizational
provider identification, excluding work agreements, site and service relationships.
1: Provider Identifier
6 Business
3 Identification
Entity
of the individual
2 Individual 5 Organisational
Provider Provider
4 Qualifications
7 Site
and
Certification
Information
Figure 2 — Individual and organizational provider identification relationships
4 © ISO 2010 – All rights reserved

It is good practice to always use name, sex and date of birth to identify individuals, and name and address to
identify organizations when manually confirming the identity of either an individual or an organization. When
communicating between systems electronically, the existence of a unique identifier may be used with some of
these elements confirming (where required) the unique identity of the individual. This Technical Specification
does not endeavour to identify the required elements for transmission between systems, as these can be
highly dependent upon local, cultural and policy factors.
Annex A provides guidance on the process, purpose and business rules suited to identification of individuals
in health care. This information will assist readers in determining the relevant components of this Technical
Specification to their situation, and support best practice in identification processes in health care.
Figure 3 indicates the data elements defined in this Technical Specification and indicates their general
relationships to each other using the broad groups (numbered) from Figure 2. The biometric requirements of
identification are not included in this Technical Specification, but can be found in detail in ISO/TS 22220.

Figure 3 — Detailed elements in provider identification
4.2 Data element structure
4.2.1 General
Each data element has been defined according to a set of metadata components that are based on
ISO/IEC 11179-3. The data set to be determined consistent with country requirements and standards. Most
components (viz. definition, data type, representational class, data domain, etc.) describe essential features of
the structure of a data element. Some components such as collection methods and comments describe
additional, non-essential features and may be left blank where appropriate.
The metadata components of each data element are described in sections 4.2.2 to 4.2.10.
4.2.2 Synonym
Alternative name(s) for this data element.
4.2.3 Definition
A statement that expresses the essential nature of the data element and its differentiation from all other data
elements.
4.2.4 Source standards
Details of established data definitions or guidelines for data elements that have been cited in this Technical
Specification are listed in Clause 2 and the Bibliography.
4.2.5 Data type
It is recognised that different users require different ways of representing concepts shown in this Technical
Specification. This Technical Specification centres on functional descriptions and use while other documents,
particularly the data types defined by HL7 use technical implementation representations. Where possible the
data type is described in a manner consistent with HL7 data types.
⎯ boolean-literal (true/false);
⎯ number (ISO 11404) (only used in this Technical Specification where arithmetic operations are
performed);
⎯ character string;
⎯ text or unconstrained text;
⎯ coded text (from an agreed vocabulary or value domain);
⎯ constrained text (where the text is associated with a formal terminology). The difference between the
coded and constrained text is the relationship to a formal, structured terminology, as opposed to a code
set, or list of values;
⎯ unique identifier;
⎯ dates/times.
Though there are other data types which are not required within this Technical Specification and are not
included here.
4.2.6 Data domain
The data domain is the values or codes acceptable for representation of the data element. The data elements
contained in this Technical Specification are either free text or coded free text. For each data element that is
coded, a code value is provided as well as a description of the code value and in some cases an alternative
code (generally an alphabetic representation). The code should be used for communication of this data value,
the descriptor is the title of the code value, and the alternative code is provided for collection of the data,
where the use of alphabetic code values is preferred at the point of data collection or for screen viewing. For
example, the data domain for the data element Sex is shown in Table 1 below:
6 © ISO 2010 – All rights reserved

Table 1 —Example of data domain representation
Code Descriptor Alternative code
1 Male M
2 Female F
3 Indeterminate I
9 Not stated/inadequately described N

It should be noted that the 'flavours of null' as defined in HL7 have not been incorporated into this Technical
Specification, rather this Technical Specification uses the structures and definitions required by
ISO/IEC 11179. Individual implementations may require consideration of the flavours of null to more clearly
define specific components.
4.2.7 Guide for use
Guide for use provides additional guidance to inform the use of the data element.
4.2.8 Verification rules
Verification rules indicate quality control mechanisms that restrict the collection, storage or transferral of
non-valid data.
4.2.9 Collection methods
Collection methods are comments and advice concerning the actual capture of data for the particular data
elements to achieve uniformly high quality data.
4.2.10 Comments (optional)
Comments are any further information relevant to data element collection or storage.
4.3 Summary of provider identifiers
This section of the Technical Specification identifies and describes the components and attributes and the
relationships between them for basic provider identification. This Technical Specification does not describe
electronic certificates that identify and authenticate an individual. The use of a public key offers this
functionality. ISO 17090 Health informatics – Public key infrastructure should be referenced for further
information on this functionality and process. For the purposes of this Technical Specification a public key is
considered a special case of an identifier (which would not be required to meet the structure suggested here).
Table 2 represents the concepts required to meet the needs of provider identification that are included and
described more fully in this Technical Specification.
Table 2 — Summary of data element structure
Section Data elements Opt. Data type Repeat
of data
document element
5 Provider identifier R Identifier Y
6 Individual provider (P – I) 0 Text Y
6.2  Individual provider name R Text Y
6.3  Individual provider demographic details R Text N
6.4  Individual provider field of practice R Text Y
7  Individual provider biometric identifier R Text Y
8 Provider organization (HCP-O) O Text Y
8.1.2  Organization start date R Date N
8.1.3  Organization start date accuracy R Coded N
indicator text
8.1.4  Organization end date O Date N
8.1.5 Provider owner identifier R Identifier Y
8.1.6 Organization name details R Text Y
8.1.7   Organization site R Text Y
9 Provider address O Text Y
10 Provider electronic communication O Text Y
NOTE:
Opt. = Indicates whether the data element is optional or required
R = Required (the group may be required, or where the group is optional the individual data
elements within the group may be marked as required. In this case, where the group exists the
required elements shall be present.
O = Optional
Identification of ‘providers’ includes the need to uniquely identify both individuals and the organizations who
provide health services. This Technical Specification includes the:
⎯ data elements needed for identification of individual providers (i.e. individuals) and their authority to
provide specific services within the system at any given point in time;
⎯ data elements needed for the identification of organizations acting as providers (i.e. organizations) and to
identify the business within which the organization works and the services provided by that organization
and the location of those services;
⎯ data elements needed for the identification of both individuals and organizations.
Unambiguous identification of an individual provider in data systems is only assured through the use of an
officially assigned identifier (e.g. a professional registration number, an identifier issued by a recognized
accreditation body or regulatory authority (e.g. a state medical registration board). Other personal
characteristics such as name, address, date of birth, sex, qualifications and/or electronic communication
details (e.g. phone, fax or email address) are an important adjunct to the process of unambiguous
identification by humans interacting with a system to identify a provider, as are the services which the person
is authorised to provide and the place at which those services are offered. These contact details are also
required to support electronic communication and access in an electronic health record environment.
Unambiguous identification of an individual provider within an organization (i.e. the combination of
organization and individual often through a specific role to provide a service at a location) requires
identification of the individual using the individual provider data elements, in addition to an organization
identifier and the identification of the specific role in which the relationship between the provider and the
organization is being invoked. This Technical Specification does not identify provider roles or the relationships
between an individual and the organization.
8 © ISO 2010 – All rights reserved

5 Provider identifier
5.1 Provider identifier introduction
Whether considering an individual or an organization, a unique identifier is required. This clause includes data
elements that are used as a unique identifier. The provider identifier is composed of five elements. These
elements together represent a unique identifier. A provider may have one or more of these identifiers, each of
which may be used for different purposes and by different health care organizations. This approach has been
adopted to allow for the identification of providers in legacy systems and through historical legal health care
documentation and processes, as these alternative identifiers are likely to continue to exist throughout health
care systems.
Clause A.5 provides details of the use of provider identifiers and the relevance of multiple identifiers to the
health care process.
Table 3 — Summary of data elements for provider identifier
Clause of Data elements Opt. Data type Repeat
document data
element
5 Provider identifier R Identifier Y
5.2 Provider identifier designation R Identifier N
5.3 Provider identifier geographic area O Coded text N
5.4 Individual or organizational identifier flag R Coded text N
5.5 Provider identifier issuer R Identifier Y
5.6 Provider identifier usage R Coded text Y
5.7 Duplicate resolution O Y
5.7.2  Not a duplicate of O Identifier N
5.7.3  Duplicate of O Identifier N
5.7.4  Confirmed by organization R Identifier Y
5.7.5  Date confirmed R Date Y
5.7.6  Retired identifier R Boolean N
NOTE:
Opt. = Indicates whether the data element is optional or required
R = Required (the group may be required, or where the group is optional the individual data
elements within the group may be marked as required. In this case, where the group exists the
required elements shall be present.
O = Optional
5.2 Provider identifier designation
Synonym Healthcare provider identifier number
Individual provider identifier number
Provider number
Individual provider identifier (IPI)
Health provider identifier – individual provider (HPI-P)
Healthcare provider organization number
Healthcare provider number
Healthcare provider organization identifier (HPI-O)
Registration number
Definition A number or code assigned to an individual or organization, agency, establishment or
domain in order to uniquely identify that provider within the system.
Source Technical ASTM E1714-00, Standard Guide for Properties of a Universal Healthcare Identifier
Specifications (UHID)
Data type Unique identifier
Data domain Identifier code
Guide for use Individual agencies, establishments or collection authorities may use their own
alphabetic, numeric or string coding systems for identification of individuals within their
own systems. However regional, national or international approaches are required for
the identification of organizations and for identification of individuals across and
between organizations.
The combination of the provider identifier designation, provider identifier usage,
provider identifier issuer, individual or organizational identifier flag and provider
identifier name, uniquely identify the provider.
ASTM E1714-00 should be used as a guide to the properties of provider identifiers.
It shall be noted that though this is a unique identifier, the identifier is only unique
within the purpose for which it was issued and for the organization responsible for
issuing the number. In other words, a single identifier may exist more than once in a
system, but when combined with the other data components of the provider identifier
the total, aggregate provider identifier is unique.
Validation rules Field may not be blank.
Collection method The following criteria and characteristics of the provider identifier are adapted from the
ASTM E1714-95 Guide for Properties of a Universal Identifier (UHID).
Atomic - the provider identifier should be a single data item. It should not contain sub-
elements that have meaning outside the context of the entire identifier. Nor should the
identifier designation consist of multiple items that shall be taken together to constitute
an identifier.
Content free - the provider identifier should not depend on possibly changing or
possibly unknown information pertaining to the provider. Including such content in the
identifier will make it impossible to assign the 'correct' identifier if that information is
not known. It also leads to invalid situations if the information changes: for example,
what happens to an identifier based on sex if the subject has a sex change procedure.
Longevity – the provider identification system should be designed to function for the
foreseeable future. It should not contain known limitations that will force the system to
be restructured or revised radically.
Permanent - once assigned, a provider identifier should remain with the individual
provider. It should never be reassigned to another subject, even after the subject's
death.
Unambiguous - whether represented in automated or handwritten form, a provider
identifier should minimize the risk of misinterpretation. Where using string identifiers,
be aware of possible confusion with the number '0' with the letter 'O' and the number
'1' with the letter 'I'.
Unique – a valid provider identifier designation should identify one and only one
provider.
5.3 Provider identifier geographic area
Definition A code representing the geographic area within which this identifier is used.
Source Technical
Specifications
Data type Coded text
10 © ISO 2010 – All rights reserved

Data domain Code Description Alternative code
1 Local identifier L
2 Area, region or district identifier A
3 State/province/territory identifier S
4 National identifier N
Verification rules
Collection method
5.4 Individual or organizational provider flag
Synonym Individual or organizational provider indicator
Definition Indicates whether this is an identifier for an individual healthcare provider or for a
healthcare organization.
Source Technical
Specifications
Data type Coded text.
Data domain Code Description Alternative representation
1 Individual provider I
2 Organizational provider O
Guide for use This is a required field.
Verification rules Field may not be blank.
Collection method
5.5 Provider identifier issuer
Synonym Provider identifier assigning authority
Definition The organization, agency or provider that allocates a provider identifier designation.
Source Technical HL7 V2 Provider identifier assigning authority (STF-2 ID code )
Specifications
HL7 V3 Authority Name
Data type Unique identifier
Data domain Unique i
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