| Name | Description | Type | Additional information |
|---|---|---|---|
| AddressLine1 | string |
None. |
|
| AddressLine2 | string |
None. |
|
| City | string |
None. |
|
| CountyId | integer |
None. |
|
| CreatedDate | date |
None. |
|
| DeceasedDate | date |
None. |
|
| GroupBeginDate | date |
None. |
|
| GroupEndDate | date |
None. |
|
| GroupNumber | string |
None. |
|
| HospitalAffiliationTypeId | byte |
None. |
|
| IsAtypicalProvider | boolean |
None. |
|
| IsPOAExempt | boolean |
None. |
|
| IsUnderReview | boolean |
None. |
|
| LicenseNumber | string |
None. |
|
| LicenseNumberExpanded | string |
None. |
|
| MedicaidNumber | string |
None. |
|
| ModifiedDate | date |
None. |
|
| Name | string |
None. |
|
| PayeeAddressLine1 | string |
None. |
|
| PayeeAddressLine2 | string |
None. |
|
| PayeeCity | string |
None. |
|
| PayeeMedicaidNumber | string |
None. |
|
| PayeeName | string |
None. |
|
| PayeeStateId | integer |
None. |
|
| PayeeZip | string |
None. |
|
| PayeeZip4 | string |
None. |
|
| PharmacyDispensingFee | decimal number |
None. |
|
| PharmacyDispensingFeeBeginDate | date |
None. |
|
| PharmacyDispensingFeeEndDate | date |
None. |
|
| PharmacyEncounterRate | decimal number |
None. |
|
| PharmacyNCPDPBeginDate | date |
None. |
|
| PharmacyNCPDPEndDate | date |
None. |
|
| PharmacyNCPDPNumber | string |
None. |
|
| PMFId | integer |
None. |
|
| PracticeTypeId | byte |
None. |
|
| ProviderEnrollDate | date |
None. |
|
| ProviderEnrollStatusId | byte |
None. |
|
| ProviderTypeId | byte |
None. |
|
| SSN | string |
None. |
|
| StateId | integer |
None. |
|
| Title | string |
None. |
|
| Zip | string |
None. |
|
| Zip4 | string |
None. |
|
| HealthPlanProviders | Collection of HealthPlanProvider |
None. |
|
| PMFEligibilitys | Collection of PMFEligibility |
None. |
|
| PMFNPIs | Collection of PMFNPI |
None. |
|
| PMFNPIPayees | Collection of PMFNPIPayee |
None. |
|
| PMFSpecialties | Collection of PMFSpecialty |
None. |
|
| County | County |
None. |
|
| HospitalAffiliationType | HospitalAffiliationType |
None. |
|
| PracticeType | PracticeType |
None. |
|
| ProverEnrollStatus | ProviderEnrollStatus |
None. |
|
| ProverType | ProviderType |
None. |
|
| State | State |
None. |
|
| PayeeState | State |
None. |