CMS NPPES Provider Dataset

About the Dataset

The CMS NPPES Provider Dataset is a comprehensive collection of relational tables tracking all Centers for Medicare & Medicaid Services (CMS) National Plan and Provider Enumeration System (NPPES) unique identification numbers (NPI) and attributes for covered health providers. Available on the Snowflake Marketplace, this dataset offers:

• Address and contact information

• License numbers across states

• Other identifiers

• Business names

• Provider taxonomies

• A full taxonomy table broken down by code, grouping, and classification

The dataset is updated weekly with delta changes and undergoes a full refresh monthly, ensuring up-to-date information.

Dataset Features

• Comprehensive Coverage: Includes all HIPAA-covered healthcare providers

• Regular Updates: Weekly delta updates and monthly full refreshes

• Rich Provider Information: Detailed attributes for each provider

• Normalized Structure: Organized into relational tables for efficient querying

Data Quality and Maintenance

Dataplex Consulting & Data Products prioritizes data quality through:

• Automated data quality checks in all pipelines

• Daily monitoring of ingestion and ETL jobs

• Timely delivery of high-quality data designed for seamless ingestion

Business Applications

Users can query various provider attributes, including:

• Specialization

• Location

• Address

• Taxonomy

• Licenses

• Identifiers

• Contact data

Example Use Cases

1. Identify all active providers with a specific primary taxonomy

2. Find all dental providers in a particular city

3. Retrieve all license numbers and states for a specific provider

4. Discover recently deactivated providers

Data Structure

The dataset is organized into several interconnected tables:

• PROVIDERS

• PROVIDERS_ADDRESSES

• PROVIDERS_LICENSES

• PROVIDERS_IDENTIFIERS

• PROVIDERS_TAXONOMIES

• TAXONOMIES

Entity Relationship Diagram

Sample Queries

1. Find providers with a specific primary taxonomy

SELECT p.npi,
       p.entity_type_value AS entity_type,
       p.provider_organization_name,
       p.provider_enumeration_date,
       p.provider_first_name,
       p.provider_other_last_name,
       p.provider_gender_code,
       p.authorized_official_telephone_number
FROM dwv.providers p
JOIN dwv.providers_taxonomies pt ON p.id = pt.provider_id
JOIN dwv.taxonomies t ON pt.taxonomy_id = t.id
WHERE pt.primary
  AND t.code = '315D00000X';

2. Query dental providers in Houston, Texas

SELECT p.npi,
       p.entity_type_value AS entity_type,
       p.provider_organization_name,
       p.provider_enumeration_date,
       p.provider_first_name,
       p.provider_last_name,
       p.provider_gender_code,
       p.authorized_official_telephone_number,
       pa.address_type,
       pa.street1,
       pa.street2,
       pa.city,
       pa.state,
       t.classification AS taxonomy_classification,
       t.grouping AS taxonomy_grouping
FROM dwv.providers p
JOIN dwv.providers_taxonomies pt ON p.id = pt.provider_id
JOIN dwv.taxonomies t ON pt.taxonomy_id = t.id
JOIN dwv.providers_addresses pa ON p.id = pa.provider_id
WHERE pa.state = 'TX'
  AND pa.city = 'HOUSTON'
  AND t.display_name LIKE '%Dentist%';

Support and Contact

For questions or assistance with the CMS NPI Provider Dataset, please contact:

Email: [email protected]

About Dataplex

Dataplex Consulting & Data Products is a provider of high-quality, turnkey data products. With over 20 years of experience serving businesses of all sizes, Dataplex offers:

• Easily accessible data for businesses

• Automatic quality checks and active monitoring

• Data consulting services

• Expertise in enhancing data management and boosting revenue