NP Core Implementation Guide
1.0.0 - Release Nepal flag

NP Core Implementation Guide - Local Development build (v1.0.0) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

Resource Profile: NP Core Practitioner - Detailed Descriptions

Active as of 2026-10-14

Definitions for the np-core-practitioner resource profile

See the documentation on how to interpret the contents of this table

0. Practitioner
Definition

A person who is directly or indirectly involved in the provisioning of healthcare.

ShortA person with a formal responsibility in the provisioning of healthcare or related services
Control0..*
Is Modifierfalse
Summaryfalse
Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
dom-3: 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 (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())
dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
dom-6: A resource should have narrative for robust management (text.`div`.exists())
np-prac-1: A practitioner must have at least one council registration identifier (Nepal Medical Council, Nepal Nursing Council, Nepal Ayurveda Medical Council, Nepal Health Professional Council, or Nepal Pharmacy Council) or a National Health Workforce Registry (NHWR) national identifier. (identifier.where( system = 'http://nmc.org.np' or system = 'http://nnc.org.np' or system = 'http://namc.org.np' or system = 'http://nhpc.org.np' or system = 'http://nepalpharmacycouncil.org.np' or system = 'http://nhwr.digitalhealth.gov.np' ).exists())
2. Practitioner.implicitRules
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.

ShortA set of rules under which this content was created
Comments

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.

Control0..1
Typeuri
Is Modifiertrue because 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
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
4. Practitioner.modifierExtension
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.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

ShortExtensions that cannot be ignored
Comments

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.

Control0..*
TypeExtension
Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
Summaryfalse
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.

Alternate Namesextensions, user content
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
6. Practitioner.identifier
Definition

An identifier that applies to this person in this role.

ShortAn identifier for the person as this agent
NoteThis is a business identifier, not a resource identifier (see discussion)
Control0..*
TypeIdentifier
Is Modifierfalse
Summarytrue
Requirements

Often, specific identities are assigned for the agent.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
SlicingThis element introduces a set of slices on Practitioner.identifier. The slices areUnordered and Open, and can be differentiated using the following discriminators:
  • value @ system
  • Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them

    8. Practitioner.identifier:nhwr
    Slice Namenhwr
    Definition

    An identifier that applies to this person in this role.

    ShortNational Health Workforce Registry codeAn identifier for the person as this agent
    NoteThis is a business identifier, not a resource identifier (see discussion)
    Control0..1*
    TypeIdentifier(National Health Workforce Registry (NHWR) Identifier)
    Is Modifierfalse
    Must Supporttrue
    Obligations
      ObligationsActor
      SHOULD:able-to-populateNP Core Creator
      SHALL:handleNP Core Consumer
      SHALL:handleNP Core Server
      Summarytrue
      Requirements

      Often, specific identities are assigned for the agent.

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      10. Practitioner.identifier:nmc
      Slice Namenmc
      Definition

      An identifier that applies to this person in this role.

      ShortNepal Medical Council registration numberAn identifier for the person as this agent
      NoteThis is a business identifier, not a resource identifier (see discussion)
      Control0..1*
      TypeIdentifier(Nepal Medical Council (NMC) Identifier)
      Is Modifierfalse
      Must Supporttrue
      Obligations
        ObligationsActor
        SHOULD:able-to-populateNP Core Creator
        SHALL:handleNP Core Consumer
        SHALL:handleNP Core Server
        Summarytrue
        Requirements

        Often, specific identities are assigned for the agent.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        12. Practitioner.identifier:nnc
        Slice Namennc
        Definition

        An identifier that applies to this person in this role.

        ShortNepal Nursing Council registration numberAn identifier for the person as this agent
        NoteThis is a business identifier, not a resource identifier (see discussion)
        Control0..1*
        TypeIdentifier(Nepal Nursing Council (NNC) Identifier)
        Is Modifierfalse
        Must Supporttrue
        Obligations
          ObligationsActor
          SHOULD:able-to-populateNP Core Creator
          SHALL:handleNP Core Consumer
          SHALL:handleNP Core Server
          Summarytrue
          Requirements

          Often, specific identities are assigned for the agent.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          14. Practitioner.identifier:namc
          Slice Namenamc
          Definition

          An identifier that applies to this person in this role.

          ShortNepal Ayurveda Medical Council registration numberAn identifier for the person as this agent
          NoteThis is a business identifier, not a resource identifier (see discussion)
          Control0..1*
          TypeIdentifier(Nepal Ayurveda Medical Council (NAMC) Identifier)
          Is Modifierfalse
          Must Supporttrue
          Obligations
            ObligationsActor
            SHOULD:able-to-populateNP Core Creator
            SHALL:handleNP Core Consumer
            SHALL:handleNP Core Server
            Summarytrue
            Requirements

            Often, specific identities are assigned for the agent.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            16. Practitioner.identifier:nhpc
            Slice Namenhpc
            Definition

            An identifier that applies to this person in this role.

            ShortNepal Health Professional Council registration numberAn identifier for the person as this agent
            NoteThis is a business identifier, not a resource identifier (see discussion)
            Control0..1*
            TypeIdentifier(Nepal Health Professional Council (NHPC) Identifier)
            Is Modifierfalse
            Must Supporttrue
            Obligations
              ObligationsActor
              SHOULD:able-to-populateNP Core Creator
              SHALL:handleNP Core Consumer
              SHALL:handleNP Core Server
              Summarytrue
              Requirements

              Often, specific identities are assigned for the agent.

              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              18. Practitioner.identifier:npc
              Slice Namenpc
              Definition

              An identifier that applies to this person in this role.

              ShortNepal Pharmacy Council registration numberAn identifier for the person as this agent
              NoteThis is a business identifier, not a resource identifier (see discussion)
              Control0..1*
              TypeIdentifier(Nepal Pharmacy Council (NPC) Identifier)
              Is Modifierfalse
              Must Supporttrue
              Obligations
                ObligationsActor
                SHOULD:able-to-populateNP Core Creator
                SHALL:handleNP Core Consumer
                SHALL:handleNP Core Server
                Summarytrue
                Requirements

                Often, specific identities are assigned for the agent.

                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                20. Practitioner.name
                Definition

                The name(s) associated with the practitioner.

                ShortThe name(s) associated with the practitioner
                Comments

                The selection of the use property should ensure that there is a single usual name specified, and others use the nickname (alias), old, or other values as appropriate.

                In general, select the value to be used in the ResourceReference.display based on this:

                1. There is more than 1 name
                2. Use = usual
                3. Period is current to the date of the usage
                4. Use = official
                5. Other order as decided by internal business rules.
                Control10..*
                TypeHumanName
                Is Modifierfalse
                Must Supporttrue
                Obligations
                  ObligationsActor
                  SHALL:able-to-populateNP Core Creator
                  SHALL:handleNP Core Consumer
                  SHALL:handleNP Core Server
                  Summarytrue
                  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.

                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  22. Practitioner.address
                  Definition

                  An address for the practitioner that follows Nepal administrative geography.


                  Address(es) of the practitioner that are not role specific (typically home address). Work addresses are not typically entered in this property as they are usually role dependent.

                  ShortPractitioner addressAddress(es) of the practitioner that are not role specific (typically home address)
                  Comments

                  The PractitionerRole does not have an address value on it, as it is expected that the location property be used for this purpose (which has an address).

                  Control0..*
                  TypeAddress(NP Core Address)
                  Is Modifierfalse
                  Must Supporttrue
                  Obligations
                    ObligationsActor
                    SHALL:populate-if-knownNP Core Creator
                    SHALL:handleNP Core Consumer
                    SHALL:handleNP Core Server
                    Summarytrue
                    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.

                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    np-addr-1: The province, district, and localLevel extensions are Nepal-specific and SHALL only be present when country is "NP". ((extension('http://fhir.digitalhealth.gov.np/core/StructureDefinition/np-core-province').exists() or extension('http://fhir.digitalhealth.gov.np/core/StructureDefinition/np-core-district').exists() or extension('http://fhir.digitalhealth.gov.np/core/StructureDefinition/np-core-local-level').exists()) implies country = 'NP')

                    See the documentation on how to interpret the contents of this table

                    0. Practitioner
                    Invariantsnp-prac-1: A practitioner must have at least one council registration identifier (Nepal Medical Council, Nepal Nursing Council, Nepal Ayurveda Medical Council, Nepal Health Professional Council, or Nepal Pharmacy Council) or a National Health Workforce Registry (NHWR) national identifier. (identifier.where( system = 'http://nmc.org.np' or system = 'http://nnc.org.np' or system = 'http://namc.org.np' or system = 'http://nhpc.org.np' or system = 'http://nepalpharmacycouncil.org.np' or system = 'http://nhwr.digitalhealth.gov.np' ).exists())
                    2. Practitioner.identifier
                    NoteThis is a business identifier, not a resource identifier (see discussion)
                    SlicingThis element introduces a set of slices on Practitioner.identifier. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                    • value @ system
                    • Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them

                      4. Practitioner.identifier:nhwr
                      Slice Namenhwr
                      ShortNational Health Workforce Registry code
                      NoteThis is a business identifier, not a resource identifier (see discussion)
                      Control0..1
                      TypeIdentifier(National Health Workforce Registry (NHWR) Identifier)
                      Must Supporttrue
                      Obligations
                        ObligationsActor
                        SHOULD:able-to-populateNP Core Creator
                        SHALL:handleNP Core Consumer
                        SHALL:handleNP Core Server
                        6. Practitioner.identifier:nmc
                        Slice Namenmc
                        ShortNepal Medical Council registration number
                        NoteThis is a business identifier, not a resource identifier (see discussion)
                        Control0..1
                        TypeIdentifier(Nepal Medical Council (NMC) Identifier)
                        Must Supporttrue
                        Obligations
                          ObligationsActor
                          SHOULD:able-to-populateNP Core Creator
                          SHALL:handleNP Core Consumer
                          SHALL:handleNP Core Server
                          8. Practitioner.identifier:nnc
                          Slice Namennc
                          ShortNepal Nursing Council registration number
                          NoteThis is a business identifier, not a resource identifier (see discussion)
                          Control0..1
                          TypeIdentifier(Nepal Nursing Council (NNC) Identifier)
                          Must Supporttrue
                          Obligations
                            ObligationsActor
                            SHOULD:able-to-populateNP Core Creator
                            SHALL:handleNP Core Consumer
                            SHALL:handleNP Core Server
                            10. Practitioner.identifier:namc
                            Slice Namenamc
                            ShortNepal Ayurveda Medical Council registration number
                            NoteThis is a business identifier, not a resource identifier (see discussion)
                            Control0..1
                            TypeIdentifier(Nepal Ayurveda Medical Council (NAMC) Identifier)
                            Must Supporttrue
                            Obligations
                              ObligationsActor
                              SHOULD:able-to-populateNP Core Creator
                              SHALL:handleNP Core Consumer
                              SHALL:handleNP Core Server
                              12. Practitioner.identifier:nhpc
                              Slice Namenhpc
                              ShortNepal Health Professional Council registration number
                              NoteThis is a business identifier, not a resource identifier (see discussion)
                              Control0..1
                              TypeIdentifier(Nepal Health Professional Council (NHPC) Identifier)
                              Must Supporttrue
                              Obligations
                                ObligationsActor
                                SHOULD:able-to-populateNP Core Creator
                                SHALL:handleNP Core Consumer
                                SHALL:handleNP Core Server
                                14. Practitioner.identifier:npc
                                Slice Namenpc
                                ShortNepal Pharmacy Council registration number
                                NoteThis is a business identifier, not a resource identifier (see discussion)
                                Control0..1
                                TypeIdentifier(Nepal Pharmacy Council (NPC) Identifier)
                                Must Supporttrue
                                Obligations
                                  ObligationsActor
                                  SHOULD:able-to-populateNP Core Creator
                                  SHALL:handleNP Core Consumer
                                  SHALL:handleNP Core Server
                                  16. Practitioner.name
                                  Control1..?
                                  Must Supporttrue
                                  Obligations
                                    ObligationsActor
                                    SHALL:able-to-populateNP Core Creator
                                    SHALL:handleNP Core Consumer
                                    SHALL:handleNP Core Server
                                    18. Practitioner.address
                                    Definition

                                    An address for the practitioner that follows Nepal administrative geography.

                                    ShortPractitioner address
                                    TypeAddress(NP Core Address)
                                    Must Supporttrue
                                    Obligations
                                      ObligationsActor
                                      SHALL:populate-if-knownNP Core Creator
                                      SHALL:handleNP Core Consumer
                                      SHALL:handleNP Core Server

                                      See the documentation on how to interpret the contents of this table

                                      0. Practitioner
                                      Definition

                                      A person who is directly or indirectly involved in the provisioning of healthcare.

                                      ShortA person with a formal responsibility in the provisioning of healthcare or related services
                                      Control0..*
                                      Is Modifierfalse
                                      Summaryfalse
                                      Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
                                      dom-3: 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 (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())
                                      dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
                                      dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
                                      dom-6: A resource should have narrative for robust management (text.`div`.exists())
                                      np-prac-1: A practitioner must have at least one council registration identifier (Nepal Medical Council, Nepal Nursing Council, Nepal Ayurveda Medical Council, Nepal Health Professional Council, or Nepal Pharmacy Council) or a National Health Workforce Registry (NHWR) national identifier. (identifier.where( system = 'http://nmc.org.np' or system = 'http://nnc.org.np' or system = 'http://namc.org.np' or system = 'http://nhpc.org.np' or system = 'http://nepalpharmacycouncil.org.np' or system = 'http://nhwr.digitalhealth.gov.np' ).exists())
                                      2. Practitioner.id
                                      Definition

                                      The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

                                      ShortLogical id of this artifact
                                      Comments

                                      The only time that a resource does not have an id is when it is being submitted to the server using a create operation.

                                      Control0..1
                                      Typeid
                                      Is Modifierfalse
                                      Summarytrue
                                      4. Practitioner.meta
                                      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.

                                      ShortMetadata about the resource
                                      Control0..1
                                      TypeMeta
                                      Is Modifierfalse
                                      Summarytrue
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      6. Practitioner.implicitRules
                                      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.

                                      ShortA set of rules under which this content was created
                                      Comments

                                      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.

                                      Control0..1
                                      Typeuri
                                      Is Modifiertrue because 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
                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                      Summarytrue
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      8. Practitioner.language
                                      Definition

                                      The base language in which the resource is written.

                                      ShortLanguage of the resource content
                                      Comments

                                      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).

                                      Control0..1
                                      BindingThe codes SHOULD be taken from CommonLanguages
                                      (preferred to http://hl7.org/fhir/ValueSet/languages|4.0.1)

                                      A human language.

                                      Additional BindingsPurpose
                                      AllLanguagesMax Binding
                                      Typecode
                                      Is Modifierfalse
                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                      Summaryfalse
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      10. Practitioner.text
                                      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.

                                      ShortText summary of the resource, for human interpretation
                                      Comments

                                      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.

                                      Control0..1
                                      TypeNarrative
                                      Is Modifierfalse
                                      Summaryfalse
                                      Alternate Namesnarrative, html, xhtml, display
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      12. Practitioner.contained
                                      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.

                                      ShortContained, inline Resources
                                      Comments

                                      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.

                                      Control0..*
                                      TypeResource
                                      Is Modifierfalse
                                      Summaryfalse
                                      Alternate Namesinline resources, anonymous resources, contained resources
                                      14. Practitioner.extension
                                      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.

                                      ShortAdditional content defined by implementations
                                      Comments

                                      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.

                                      Control0..*
                                      TypeExtension
                                      Is Modifierfalse
                                      Summaryfalse
                                      Alternate Namesextensions, user content
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                      16. Practitioner.modifierExtension
                                      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.

                                      Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                      ShortExtensions that cannot be ignored
                                      Comments

                                      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.

                                      Control0..*
                                      TypeExtension
                                      Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
                                      Summaryfalse
                                      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.

                                      Alternate Namesextensions, user content
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                      18. Practitioner.identifier
                                      Definition

                                      An identifier that applies to this person in this role.

                                      ShortAn identifier for the person as this agent
                                      NoteThis is a business identifier, not a resource identifier (see discussion)
                                      Control0..*
                                      TypeIdentifier
                                      Is Modifierfalse
                                      Summarytrue
                                      Requirements

                                      Often, specific identities are assigned for the agent.

                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      SlicingThis element introduces a set of slices on Practitioner.identifier. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                      • value @ system
                                      • Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them

                                        20. Practitioner.identifier:nhwr
                                        Slice Namenhwr
                                        Definition

                                        An identifier that applies to this person in this role.

                                        ShortNational Health Workforce Registry code
                                        NoteThis is a business identifier, not a resource identifier (see discussion)
                                        Control0..1
                                        TypeIdentifier(National Health Workforce Registry (NHWR) Identifier)
                                        Is Modifierfalse
                                        Must Supporttrue
                                        Obligations
                                          ObligationsActor
                                          SHOULD:able-to-populateNP Core Creator
                                          SHALL:handleNP Core Consumer
                                          SHALL:handleNP Core Server
                                          Summarytrue
                                          Requirements

                                          Often, specific identities are assigned for the agent.

                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          22. Practitioner.identifier:nmc
                                          Slice Namenmc
                                          Definition

                                          An identifier that applies to this person in this role.

                                          ShortNepal Medical Council registration number
                                          NoteThis is a business identifier, not a resource identifier (see discussion)
                                          Control0..1
                                          TypeIdentifier(Nepal Medical Council (NMC) Identifier)
                                          Is Modifierfalse
                                          Must Supporttrue
                                          Obligations
                                            ObligationsActor
                                            SHOULD:able-to-populateNP Core Creator
                                            SHALL:handleNP Core Consumer
                                            SHALL:handleNP Core Server
                                            Summarytrue
                                            Requirements

                                            Often, specific identities are assigned for the agent.

                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            24. Practitioner.identifier:nnc
                                            Slice Namennc
                                            Definition

                                            An identifier that applies to this person in this role.

                                            ShortNepal Nursing Council registration number
                                            NoteThis is a business identifier, not a resource identifier (see discussion)
                                            Control0..1
                                            TypeIdentifier(Nepal Nursing Council (NNC) Identifier)
                                            Is Modifierfalse
                                            Must Supporttrue
                                            Obligations
                                              ObligationsActor
                                              SHOULD:able-to-populateNP Core Creator
                                              SHALL:handleNP Core Consumer
                                              SHALL:handleNP Core Server
                                              Summarytrue
                                              Requirements

                                              Often, specific identities are assigned for the agent.

                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              26. Practitioner.identifier:namc
                                              Slice Namenamc
                                              Definition

                                              An identifier that applies to this person in this role.

                                              ShortNepal Ayurveda Medical Council registration number
                                              NoteThis is a business identifier, not a resource identifier (see discussion)
                                              Control0..1
                                              TypeIdentifier(Nepal Ayurveda Medical Council (NAMC) Identifier)
                                              Is Modifierfalse
                                              Must Supporttrue
                                              Obligations
                                                ObligationsActor
                                                SHOULD:able-to-populateNP Core Creator
                                                SHALL:handleNP Core Consumer
                                                SHALL:handleNP Core Server
                                                Summarytrue
                                                Requirements

                                                Often, specific identities are assigned for the agent.

                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                28. Practitioner.identifier:nhpc
                                                Slice Namenhpc
                                                Definition

                                                An identifier that applies to this person in this role.

                                                ShortNepal Health Professional Council registration number
                                                NoteThis is a business identifier, not a resource identifier (see discussion)
                                                Control0..1
                                                TypeIdentifier(Nepal Health Professional Council (NHPC) Identifier)
                                                Is Modifierfalse
                                                Must Supporttrue
                                                Obligations
                                                  ObligationsActor
                                                  SHOULD:able-to-populateNP Core Creator
                                                  SHALL:handleNP Core Consumer
                                                  SHALL:handleNP Core Server
                                                  Summarytrue
                                                  Requirements

                                                  Often, specific identities are assigned for the agent.

                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  30. Practitioner.identifier:npc
                                                  Slice Namenpc
                                                  Definition

                                                  An identifier that applies to this person in this role.

                                                  ShortNepal Pharmacy Council registration number
                                                  NoteThis is a business identifier, not a resource identifier (see discussion)
                                                  Control0..1
                                                  TypeIdentifier(Nepal Pharmacy Council (NPC) Identifier)
                                                  Is Modifierfalse
                                                  Must Supporttrue
                                                  Obligations
                                                    ObligationsActor
                                                    SHOULD:able-to-populateNP Core Creator
                                                    SHALL:handleNP Core Consumer
                                                    SHALL:handleNP Core Server
                                                    Summarytrue
                                                    Requirements

                                                    Often, specific identities are assigned for the agent.

                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    32. Practitioner.active
                                                    Definition

                                                    Whether this practitioner's record is in active use.

                                                    ShortWhether this practitioner's record is in active use
                                                    Comments

                                                    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.

                                                    Control0..1
                                                    Typeboolean
                                                    Is Modifierfalse
                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                    Summarytrue
                                                    Requirements

                                                    Need to be able to mark a practitioner record as not to be used because it was created in error.

                                                    Meaning if MissingThis resource is generally assumed to be active if no value is provided for the active element
                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    34. Practitioner.name
                                                    Definition

                                                    The name(s) associated with the practitioner.

                                                    ShortThe name(s) associated with the practitioner
                                                    Comments

                                                    The selection of the use property should ensure that there is a single usual name specified, and others use the nickname (alias), old, or other values as appropriate.

                                                    In general, select the value to be used in the ResourceReference.display based on this:

                                                    1. There is more than 1 name
                                                    2. Use = usual
                                                    3. Period is current to the date of the usage
                                                    4. Use = official
                                                    5. Other order as decided by internal business rules.
                                                    Control1..*
                                                    TypeHumanName
                                                    Is Modifierfalse
                                                    Must Supporttrue
                                                    Obligations
                                                      ObligationsActor
                                                      SHALL:able-to-populateNP Core Creator
                                                      SHALL:handleNP Core Consumer
                                                      SHALL:handleNP Core Server
                                                      Summarytrue
                                                      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.

                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      36. Practitioner.telecom
                                                      Definition

                                                      A contact detail for the practitioner, e.g. a telephone number or an email address.

                                                      ShortA contact detail for the practitioner (that apply to all roles)
                                                      Comments

                                                      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.

                                                      Control0..*
                                                      TypeContactPoint
                                                      Is Modifierfalse
                                                      Summarytrue
                                                      Requirements

                                                      Need to know how to reach a practitioner independent to any roles the practitioner may have.

                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      38. Practitioner.address
                                                      Definition

                                                      An address for the practitioner that follows Nepal administrative geography.

                                                      ShortPractitioner address
                                                      Comments

                                                      The PractitionerRole does not have an address value on it, as it is expected that the location property be used for this purpose (which has an address).

                                                      Control0..*
                                                      TypeAddress(NP Core Address)
                                                      Is Modifierfalse
                                                      Must Supporttrue
                                                      Obligations
                                                        ObligationsActor
                                                        SHALL:populate-if-knownNP Core Creator
                                                        SHALL:handleNP Core Consumer
                                                        SHALL:handleNP Core Server
                                                        Summarytrue
                                                        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.

                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        np-addr-1: The province, district, and localLevel extensions are Nepal-specific and SHALL only be present when country is "NP". ((extension('http://fhir.digitalhealth.gov.np/core/StructureDefinition/np-core-province').exists() or extension('http://fhir.digitalhealth.gov.np/core/StructureDefinition/np-core-district').exists() or extension('http://fhir.digitalhealth.gov.np/core/StructureDefinition/np-core-local-level').exists()) implies country = 'NP')
                                                        40. Practitioner.gender
                                                        Definition

                                                        Administrative Gender - the gender that the person is considered to have for administration and record keeping purposes.

                                                        Shortmale | female | other | unknown
                                                        Control0..1
                                                        BindingThe codes SHALL be taken from AdministrativeGender
                                                        (required to http://hl7.org/fhir/ValueSet/administrative-gender|4.0.1)

                                                        The gender of a person used for administrative purposes.

                                                        Typecode
                                                        Is Modifierfalse
                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                        Summarytrue
                                                        Requirements

                                                        Needed to address the person correctly.

                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        42. Practitioner.birthDate
                                                        Definition

                                                        The date of birth for the practitioner.

                                                        ShortThe date on which the practitioner was born
                                                        Control0..1
                                                        Typedate
                                                        Is Modifierfalse
                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                        Summarytrue
                                                        Requirements

                                                        Needed for identification.

                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        44. Practitioner.photo
                                                        Definition

                                                        Image of the person.

                                                        ShortImage of the person
                                                        Control0..*
                                                        TypeAttachment
                                                        Is Modifierfalse
                                                        Summaryfalse
                                                        Requirements

                                                        Many EHR systems have the capability to capture an image of patients and personnel. Fits with newer social media usage too.

                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        46. Practitioner.qualification
                                                        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.

                                                        ShortCertification, licenses, or training pertaining to the provision of care
                                                        Control0..*
                                                        TypeBackboneElement
                                                        Is Modifierfalse
                                                        Summaryfalse
                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        48. Practitioner.qualification.id
                                                        Definition

                                                        Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                        ShortUnique id for inter-element referencing
                                                        Control0..1
                                                        Typestring
                                                        Is Modifierfalse
                                                        XML FormatIn the XML format, this property is represented as an attribute.
                                                        Summaryfalse
                                                        50. Practitioner.qualification.extension
                                                        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.

                                                        ShortAdditional content defined by implementations
                                                        Comments

                                                        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.

                                                        Control0..*
                                                        TypeExtension
                                                        Is Modifierfalse
                                                        Summaryfalse
                                                        Alternate Namesextensions, user content
                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                        52. Practitioner.qualification.modifierExtension
                                                        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.

                                                        Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                        ShortExtensions that cannot be ignored even if unrecognized
                                                        Comments

                                                        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.

                                                        Control0..*
                                                        TypeExtension
                                                        Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                        Summarytrue
                                                        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.

                                                        Alternate Namesextensions, user content, modifiers
                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                        54. Practitioner.qualification.identifier
                                                        Definition

                                                        An identifier that applies to this person's qualification in this role.

                                                        ShortAn identifier for this qualification for the practitioner
                                                        NoteThis is a business identifier, not a resource identifier (see discussion)
                                                        Control0..*
                                                        TypeIdentifier
                                                        Is Modifierfalse
                                                        Summaryfalse
                                                        Requirements

                                                        Often, specific identities are assigned for the qualification.

                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        56. Practitioner.qualification.code
                                                        Definition

                                                        Coded representation of the qualification.

                                                        ShortCoded representation of the qualification
                                                        Control1..1
                                                        BindingFor example codes, see v2 table 0360, Version 2.7
                                                        (example to http://terminology.hl7.org/ValueSet/v2-2.7-0360)

                                                        Specific qualification the practitioner has to provide a service.

                                                        TypeCodeableConcept
                                                        Is Modifierfalse
                                                        Summaryfalse
                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        58. Practitioner.qualification.period
                                                        Definition

                                                        Period during which the qualification is valid.

                                                        ShortPeriod during which the qualification is valid
                                                        Control0..1
                                                        TypePeriod
                                                        Is Modifierfalse
                                                        Summaryfalse
                                                        Requirements

                                                        Qualifications are often for a limited period of time, and can be revoked.

                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        60. Practitioner.qualification.issuer
                                                        Definition

                                                        Organization that regulates and issues the qualification.

                                                        ShortOrganization that regulates and issues the qualification
                                                        Control0..1
                                                        TypeReference(Organization)
                                                        Is Modifierfalse
                                                        Summaryfalse
                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        62. Practitioner.communication
                                                        Definition

                                                        A language the practitioner can use in patient communication.

                                                        ShortA language the practitioner can use in patient communication
                                                        Comments

                                                        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.

                                                        Control0..*
                                                        BindingThe codes SHOULD be taken from CommonLanguages
                                                        (preferred to http://hl7.org/fhir/ValueSet/languages|4.0.1)

                                                        A human language.

                                                        Additional BindingsPurpose
                                                        AllLanguagesMax Binding
                                                        TypeCodeableConcept
                                                        Is Modifierfalse
                                                        Summaryfalse
                                                        Requirements

                                                        Knowing which language a practitioner speaks can help in facilitating communication with patients.

                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))