Data extract file format

Use the data extract file format table as a reference when performing a data extract.

File format

The extract(s) should conform to the format shown in the following table (the various fields from the sources are mapped accordingly and any fields not used by a source are left null but still have a pipe delimiter to preserve consistent field positions).
Table 1. Data extract file format for individual and organizational providers
Field No. Field Description Max Length Format
1. Source* Identifies source of data 40 Text
2. Source ID Unique to source 60 Text
3. Provider last name Provider’s Last Name 75 Text
4. Provider first name Provider’s First Name 30 Text
5. Provider middle name Provider’s Middle Name 30 Text
6. Provider name suffix Provider Suffix. This can be included with the Last Name also, if that is how the client has their data. 10 Text
7. Provider Business Name Business Name 128 Text
8. Federal Tax ID Federal Tax ID 40 Text
9. Birth Date Date of Birth 10 YYYYMMDD
10. Gender Gender 10 Text
11. Primary Address Line 1 Provider Primary Address Line 1 75 Text
12. Primary Address Line 2 Provider Primary Address Line 2 75 Text
13. Primary City Provider Primary Address City 30 Text
14. Primary State Provider Primary Address State 2 Text
15. Primary Zip Code Provider Primary Address Postal code 10 Text
16. Business Address Line 1 Address Line 1 - Business 75 Text
17. Business Address Line 2 Address Line 2 - Business 75 Text
18. Business City City - Business 30 Text
19. Business State State - Business 2 Text
20. Business Zip Code Postal Code - Business 10 Text
21. Billing Address Line 1 Address Line 1 - Billing 75 Text
22. Billing Address Line 2 Address Line 2 - Billing 75 Text
23. Billing City City - Billing 30 Text
24. Billing State State - Billing 2 Text
25. Billing Zip Code Postal code - Billing 10 Text
26. Other Address Line 1 Address Line 1 - Other 75 Text
27. Other Address Line 2 Address Line 2 - Other 75 Text
28. Other City City - Other 30 Text
29. Other State State - Other 2 Text
30. Other Zip Code Postal code - Other 10 Text
31. Primary Phone Area Code Primary Phone Area Code 3 XXX (Text)
32. Primary Phone Number Primary Phone Number 20 Text
33. Business Phone Area Code Business Phone Area Code 3 XXX (Text)
34. Business Phone Number Business Phone Number 20 Text
35. Degree Date Degree Date 10 YYYYMMDD
36. Degree Received Degree Received 30 Text
37. Education Education 30 Text
38. Fax Number Area Code Fax Number Area Code 3 XXX (Text)
39. Fax Number Fax Number 20 Text
40. Emergency Fax Emergency Fax Number 20 Text
41. Emergency Mobile Emergency Mobile Number 20 Text
42. Emergency Office Phone Emergency Office Phone Number 20 Text
43. Emergency Pager Emergency Pager Number 20 Text
44. Other Phone Area Code Other Phone Area Code 3 XXX (Text)
45. Other Phone Number Other Phone Number 20 Text
46. National Provider Identifier National Provider Identifier (NPI) 40 Text
47. Drug Enforcement Administration ID Drug Enforcement Administration ID (DEA ID) 40 Text
48. Unique Physician Identification Number Unique Physician Identification Number (UPIN) 40 Text
49. Medicare ID Medicare ID 40 Text
50. Medicaid ID Medicaid ID 40 Text
51. State ID State ID 40 Text
52. State ID Issue Date State ID Issue Date 10 YYYY-MM-DD
53. State ID License Status State ID License Status 128 Text
54. Email Address Email Address 128 Text
55. Web Address Web Address 128 Text
56. Board Certification Board Certification 128 Text
57. Credentials Credentials 128 Text
58. Facility Facility 128 Text
59. License Class License Class 128 Text
60. License Date License Date 10 YYYYMMDD
61. License ID License ID 128 Text
62. License Method License Method 128 Text
63. License Status License Status 128 Text
64. Registration Status Registration Status 128 Text
65. Specialty Specialty 128 Text or Enumerated Data: <LIST OF SPECIALTIES>
66. Status Status 128 Text
67. Organization Affiliation Organization Affiliation 128 Text
68. Primary Delivery Preferences Primary Delivery Preferences 30 Text
69. Business Delivery Preferences Business Delivery Preferences 30 Text
70. Other Delivery Preferences Other Delivery Preferences 30 Text
71. Employed by Organization Employed by Organization 128 Text
72. HIE Service Provider HIE Service Provider 30 Text
73. Language Language 30 Text
74. Type of Training Type of Training 30 Text
75. Organization Provider Name Organization Provider Name 75 Text
76 Organization Other Known Name Known Name 75 Text
77. Primary Clinical Info Contact Clinical Info Contact 128 Text
78. Billing Clinical Info Contact Clinical Info Contact 128 Text
79. Business Clinical Info Contact Clinical Info Contact 128 Text
80. Other Clinical Info Contact Clinical Info Contact 128 Text
81. Organization Primary Address Line 1 Primary Address Line 1 75 Text
82. Organization Primary Address Line 2 Primary Address Line 2 75 Text
83. Organization City City 50 Text
84. Organization State State 15 Text
85. Organization Zip Code Postal Code 10 Text
86. Organization Other Address Line 1 Other Address Line 1 75 Text
87. Organization Other Address Line 2 Other Address Line 2 75 Text
88. Organization Other Address City Other Address City 50 Text
89. Organization Other Address State Other Address State 15 Text
90.91. Organization Other Address Zip Code Other Address Postal Code 10 Text
92. Organization Primary Phone Primary Phone 20 Text
93. Organization Other Office Name Other Office Name 75 Text
94. Organization Other Phone Other Phone 20 Text
95. Organization Primary Delivery Preference Delivery Preference 30 Text
96. Organization Primary Email Primary Email 128 Text
97. Organization Primary Fax Primary Fax 20 Text
98. Organization Specialty Specialty 128 Text
99. Organization State ID State ID 40 Text
100. Organization State ID Issue Date Organization State ID Issue Date 10 YYYYMMDD
101. Organization State ID License Status State ID License Status 128 Text
102. Organization Status Status 30 Text
103. Organization Type Role/Provider Type 30 Text
104. Other Clinical Info Contact Clinical Info Contact 128 Text
105. Other Electronic Service URI Electronic Service URI 128 Text
106. Other Organization Certificate Organization Certificate 128 Text
107. Other Signing Certificate Signing Certificate 128 Text
108. Primary Clinical Info Contact Clinical Info Contact 128 Text
109. Primary Clinical Info Contact Mail Primary Clinical Info Contact Mail 128 Text
110. Primary Clinical Info Contact Phone Primary Clinical Info Contact Phone 20 Text
111. Primary Electronic Service URL Electronic Service URL 128 Text
112. Primary Organization Certificate Organization Certificate 128 Text
113. Primary Organization URL Primary Organization URL 128 Text
114. Primary Signing Certificate Signing Certificate 128 Text
115. Public or Private Public or Private 128 Text

Assumptions

When preparing your data extract, keep the following in mind:

  • *Bold fields are required.
  • Source Identifier is unique within the source.
  • Standard data load files for the software are pipe { | } delimited and include one header record with the source and extract date.
  • Files are flat and will have CRLF present at the end of each line.
  • Files are ASCII unless otherwise specified.
  • Delimited files require field placement.
  • All dates are in YYYYMMDD format.
  • Max Length indicates the maximum allowable length for data in the field (excess characters are dropped).