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NPDB Research Statistics

Definitions and Terms

The following vocabulary and terminology are associated with the National Practitioner Data Bank (NPDB) and apply to the NPDB, its policies, and procedures.

Adverse Action Report (AAR) - the report format used to submit actions, other than medical malpractice payments and convictions and judgments, taken against a health care practitioner, entity, provider, or supplier. AARs in this NPDB Research Statistics page reflect actions against health care practitioners only.

Adversely affects - reduces, restricts, suspends, revokes, or denies clinical privileges or membership in a health care entity.

Authorized agent - an individual or organization that an eligible entity designates to query the NPDB on its behalf. In most cases, an authorized agent is an independent contractor to the requesting entity (for instance, a county medical society or state hospital association) used for centralized credentialing. An authorized agent cannot query the NPDB without designation from an eligible entity.

Authorized submitter - an individual empowered by an eligible entity to submit reports or queries to the NPDB. The authorized submitter certifies the legitimacy of information in a query or report submitted to the NPDB. In most cases, the authorized submitter is an employee of the eligible entity (such as an Administrator or Medical Staff Director).

Board of Medical Examiners - a body or subdivision of such body that is designated by a State for licensing, monitoring, and disciplining physicians or dentists. This term includes boards of allopathic or osteopathic examiners, a composite board, a subdivision, or an equivalent body as determined by the State.

Clinical privileges - privileges, membership on the medical staff, and other circumstances (including panel memberships) in which a physician, dentist, or other licensed health care practitioner is permitted to furnish medical care by a health care entity.

Dentist - a doctor of dental surgery, a doctor of dental medicine, or the equivalent who is legally authorized to practice dentistry by a State, or who, without authority, holds himself or herself out to be so authorized (includes residents).

Department of Health and Human Services (DHHS) - the Federal Government agency responsible for administering the NPDB.

Drug Enforcement Administration (DEA) - the Federal Government agency that registers practitioners to dispense controlled substances and assigns practitioners Federal DEA Numbers.

Formal peer review process - the conduct of professional review activities through formally adopted written procedures that provide for adequate notice and an opportunity for a hearing.

Freedom of Information Act (FOIA) - the law that provides public access to Federal Governmental records.

Health Care Practitioner, Licensed Health Care Practitioner, Licensed Practitioner, or Practitioner - defined in NPDB regulations as “an individual who is licensed or otherwise authorized by a state to provide health care services (or any individual who, without authority, holds himself or herself out to be so licensed or authorized).”

Health Care Quality Improvement Act of 1986, as amended - Title IV of Public Law 99-660; legislation intended to improve the quality of medical care by encouraging hospitals, State Licensing Boards, and other health care entities, including professional societies, to identify and discipline those who engage in unprofessional behavior; and to restrict the ability of incompetent practitioners to move from State to State without disclosure or discovery of the practitioners' previous damaging or incompetent performance.

Health care entity - (1) a hospital; (2) an entity that provides health care services and follows a formal peer review process for the purpose of furthering quality health care; or (3) a professional society or a committee or agent thereof, including those at the national, State, or local level, of physicians, dentists, or other health care practitioners, that follows a formal peer review process for the purpose of furthering quality health care.

Hospital [as described in Section 1861(e)(1) and (7) of the Social Security Act] - an institution primarily engaged in providing, by or under the supervision of physicians, to inpatients (1) diagnostic services and therapeutic services for medical diagnosis, treatment, and care of injured, disabled, or sick persons; or (2) rehabilitation services for the rehabilitation of injured, disabled, or sick persons, and, if required by State or local law, is licensed or is approved by the agency of the State or locality responsible for licensing hospitals as meeting the standards established for such licensing.

Inflation Adjusted - the inflation adjustment uses the Bureau of Labor Statistics June 2017 seasonally adjusted (SA) CPI-U, US City Average, All Items. For 1990, we use the September figure. For all other years , we use the June figure to compute the inflation factor that is applied to each payment range.

Medical malpractice payer - an entity that makes a medical malpractice payment through an insurance policy or otherwise for the benefit of a practitioner.

Medical malpractice payment - a monetary exchange as a result of a settlement or judgment of a written complaint or claim demanding payment based on a physician's, dentist's, or other licensed health care practitioner's provision of or failure to provide health care services, and may include, but is not limited to, the filing of a cause of action, based on the law of tort, brought in any State or Federal Court or other adjudicative body.

Medical Malpractice Payment Report - the format used by medical malpractice payers to report a medical malpractice payment made for the benefit of a physician, dentist, or other health care practitioner.

Occupation/Field of Licensure Codes - a list of occupational activities/licensure categories for health care practitioners, providers, and suppliers, and the codes used to identify them.

Physician - a doctor of medicine or osteopathy who is legally authorized to practice medicine or surgery by a State, or who, without authority, holds himself or herself out to be so authorized (includes residents and interns).

Other Territories - includes American Samoa, Marshall Islands, Virgin Islands, Northern Mariana Islands, Palau, Federated States of Micronesia and Guam. Data for Puerto Rico is listed separately.

Practitioner Type - grouping used to classify practitioners into a fixed number of nominal groups to facilitate analysis. The practitioner grouping for each type along with the associated NPDB Public Use File licensure codes are summarized in the following table:

Practitioner Type Code Label
Physician (MD) 010 Physician (MD)
015 Physician Intern/Resident (MD)
Physician (DO) 020 Osteopathic Physician (DO)
025 Osteopathic Physician Intern/Resident (DO)
Chiropractor 603 Chiropractor
604 Chiropractic Assistant
605 Other Chiropractic Occupation - Not Classified
Dental Hygienist/Assistant 606 Dental Assistant
607 Dental Therapist/Dental Health Aide
609 Dental Hygienist
612 Denturist
613 Other Dental Occupation, Not Classified

Dentist

030 Dentist
035 Dental Resident
Nurse - Advanced Practice Nurse 110 Nurse Anesthetist
120 Nurse Midwife
130 Nurse Practitioner
134 (Retired Code) Doctor of Nursing Practice
135 (Retired Code) Advance Practice Nurse
141 Clinical Nurse Specialist
Nurse - Registered Nurse 100 Registered (Professional) Nurse
Nurse - Practical Nurse 140 Licensed Practical or Vocational Nurse
142 Other Nurse Occupation - Not Classified
Nursing Para-Professionals 148 Certified Nurse Aide/Certified Nursing Assistant
150 Nurses Aide
160 Home Health Aide (Homemaker)
165 Health Care Aide/Direct Care Worker
175 Certified or Qualified Medication Aide
176 Other Aide Occupation - Not Classified
Optometrist 630 Ocularist
633 Optician
636 Optometrist
637 Other Eye and Vision Service Occupation - Not Classified
Pharmacist 050 Pharmacist
055 Pharmacy Intern
060 Pharmacist Nuclear
076 Other Pharmacy Service Occupation - Not Classified
Physician Assistant 642 Physician Assistant (MD)
645 Physician Assistant (DO)
Podiatrist 350 Podiatrist
649 Other Podiatric Service Occupation - Not Classified
Psychologist 370 (Retired Code) Clinical Psychologist
371 Psychologist
372 School Psychologist
374 Other Psychologist/Psychological Assistant Occupation - Not Classified
Social Worker 300 Clinical Social Worker
Technicians and Assistants 070 Pharmacy Assistant
075 Pharmacy Technician
170 Psychiatric Technician
250 EMT, Basic
260 EMT, Cardiac/Critical Care
270 EMT, Intermediate
280 EMT, Paramedic
281 Other Emergency Medical Technician Occupation - Not Classified
373 Psychological Assistant, Associate, Examiner
420 Occupational Therapy Assistant
440 Physical Therapy Assistant
470 Hearing Aid Specialist, Dealer, Dispenser, or Filter
471 Other Speech, Language, and Hearing Service Occupation - Not Classified
500 (Retired Code) Medical Technologist
501 Medical or Clinical Laboratory Technologist
502 Medical or Clinical Laboratory Technician
503 Surgical Technologist
504 Surgical Assistant
505 Cytotechnologist
510 Nuclear Medicine Technologist
520 Radiation Therapy Technologist
530 Radiologic Technologist
540 X-Ray Technician or Operator
550 Limited X-Ray Machine Operator
551 Other Technologist/Technician - Not Classified
618 Medical Assistant
639 Orthotics/Prosthetics Fitter
647 Perfusionist
648 Podiatric Assistant
666 Respiratory Therapy Technician
Therapists and Counselors 402 Art/Recreation Therapist
405 Massage Therapist
410 Occupational Therapist
430 Physical Therapist
450 Rehabilitation Therapist
621 Counselor, Mental Health
651 Professional Counselor
652 Sex Offender Counselor
653 Pastoral Counselor
654 Professional Counselor, Alcohol
657 Professional Counselor, Family/Marriage
658 Other Rehabilitative, Respiratory, and Restorative Service Occupation
660 Professional Counselor, Substance Abuse
661 Marriage and Family Therapist
662 Art Therapist
663 Respiratory Therapist
664 Recreation Therapist
665 Dance Therapist
667 Music Therapist
668 Other Behavioral Health Occupation - Not Classified
Other 200 Dietitian
210 Nutritionist
211 Other Dietitian/Nutritionist - Not Classified
400 Audiologist
460 Speech/Language Pathologist
600 Acupuncturist
601 Athletic Trainer
615 Homeopath
624 Midwife, Lay (Non-Nurse)
627 Naturopath
699 Other Health Care Practitioner - Not Classified

Note: * Practitioners that do not have a Field of Licensure listed are not included.


Privacy Act - the law that establishes safeguards for the protection of Federal systems of records the Government collects and keeps on individual persons.

Professional review action - an action or recommendation of a health care entity:

  • (1) taken in the course of professional review activity;
  • (2) based on the professional competence or professional conduct of an individual physician, dentist, or other health care practitioner which affects or could affect adversely the health or welfare of a patient or patients; and
  • (3) which adversely affects or may adversely affect the clinical privileges of the physician, dentist, or other health care practitioner.

The term professional review action excludes actions which are primarily based on:

  • (a) the physician's, dentist's, or other health care practitioner's association, or lack of association, with a professional society or association;
  • (b) the physician's, dentist's, or other health care practitioner's fees or the physician's, dentist's, or other health care practitioner's advertising or engaging in other competitive acts intended to solicit or retain business;
  • (c) the physician's, dentist's, or other health care practitioner's participation in prepaid group health plans, salaried employment, or any other manner of delivering health services whether on a fee-for-service or other basis;
  • (d) a physician's, dentist's, or other health care practitioner's association with, supervision of, delegation of authority to, support for, training of, or participation in a private group practice with, a member or members of a particular class of health care practitioner or professional; or
  • (e) any other matter that does not relate to the professional competence or professional conduct of a physician, dentist, or other health care practitioner.

Professional review activity - an activity of a health care entity with respect to an individual physician, dentist, or other health care practitioner:

  • (1) to determine whether the physician, dentist, or other health care practitioner may have clinical privileges with respect to, or membership in, the entity;
  • (2) to determine the scope or conditions of such privileges or membership; or
  • (3) to change or modify such privileges or membership.

Professional society - an association of physicians or dentists that follows a formal peer review process for the purpose of furthering quality health care.

Query - a request for information submitted to the NPDB by an eligible entity or authorized agent.

Report - record of a medical malpractice payment or adverse action submitted to the NPDB by an eligible entity.

Secretary - the Secretary of Health and Human Services.

Section 1128E of the Social Security Act - enacted as Section 221(a) of the Health Insurance Portability and Accountability Act of 1996, Public Law 104-191. One of the three enabling statutes underlying the NPDB. Reports collected under Section 1128E are not included in this NPDB Research Statistics page.

Section 1921 of the Social Security Act - enacted as Section 5 of the Medicare and Medicaid Patient and Program Protection Act of 1987, Public Law 100-93. One of the three enabling statutes underlying the NPDB.

Self-query - a subject's request for information contained in the NPDB about himself or herself.

State - the 50 States, the District of Columbia, Puerto Rico, the Armed Forces, and other territories. In this tool, state is defined as the reporting entity state for state licensure actions. For clinical privileges actions in Federal agencies, state is defined as the practitioner's work state. For non-Federal clinical privileges actions, state is defined as the reporting entity state. If work state is not available, then the practitioner's home state is used. If both work state and home state are unavailable, then the practitioner's license state is used. For all other reports, including medical malpractice payment reports, state is defined as the practitioner's work state. If work state is not available, then the practitioner's home state is used. If both work state and home state are unavailable, then the practitioner's license state is used.

State Licensing Board - a generic term used to refer to State medical and dental boards, as well as those bodies responsible for licensing, certifying, or otherwise authorizing physicians, dentists, or other health care practitioners to provide health care services. See also Board of Medical Examiners, State Licensing or Certification Authority, and State Medical or Dental Board.

State Licensing or Certification Agency - defined in NPDB regulations as “includes, but is not limited to, any authority of a state (or of a political subdivision thereof) responsible for the licensing or certification of health care practitioners (or any peer review organization or private accreditation entity reviewing the services provided by health care practitioners), health care entities, providers, or suppliers. Examples of such state agencies include Departments of Professional Regulation, Health, Social Services (including State Survey and Certification and Medicaid Single State agencies), Commerce, and Insurance.”

State Licensing or Certification Authority - a State Government body that: licenses, certifies, registers, or otherwise authorizes health care practitioners, entities, providers, or suppliers to provide health care services; and/or certifies physicians, dentists, other health care practitioners, entities, providers, or suppliers for participation in a Federal or State health care program. Examples of such State agencies include departments of professional regulation, health, social services (including State survey and certification and Medicaid single State agencies), commerce, and insurance.

State Medical or Dental Board - a board of medical examiners.

Title IV - Title IV of the Health Care Quality Improvement Act of 1986, Public Law 99-660. One of the three enabling statutes underlying the NPDB.

Unique Practitioner - one practitioner can be counted in multiple types and in multiple states, which would cause a summation of either category to be greater than the actual unique practitioner count.

Year - Adverse Action Reports use the year the action was taken and Medical Malpractice Payment Reports use the year of the payment.