| 76470-4 | Federal employer tax ID Organization | |
| 76469-6 | Organization Name | |
| 76696-4 | Name Fclty | |
| 45952-9 | National provider ID:ID:Pt:Provider:Nom: | |
| 76419-1 | Provider Last name | |
| 76417-5 | Provider First name | |
| 89550-8 | Middle name Provider | |
| 81886-4 | Sex of Provider | |
| 82157-9 | Birth Date Provider | |
| 81887-2 | Provider race OMB.1997 | |
| 81888-0 | Provider ethnicity OMB.1997 | |
| 76420-9 | Provider Grad year | |
| 82158-7 | Grad state Provider | |
| 76421-7 | PT provider type APTA | |
| 81889-8 | PT Prov entry-level degree | |
| 81890-6 | PT Prov highest educ | |
| 76457-1 | PT provider residency or fellowship APTA | |
| 76422-5 | PT provider specialty APTA | |