taxonomy provider provider type provider provider specialty ic … · 2019-07-17 · clinic/center...
TRANSCRIPT
TennCare Taxonomy Crosswalk 7/17/2019
TAXONOMY
Grouping 1
TAXONOMY
Grouping 2
TAXONOMY
Grouping 3DESCRIPTION TAXONOMY
Provider
Type
Provider Type
Description
Provider
Specialty
Provider Specialty
Description
iC Fund
Code
Healthcare
Prov
Non-individual Hospital Units Epilepsy Unit Epilepsy Unit**** 273100000X 01 Inpatient Facility 010 Acute Care Y N
Non-individual Hospital Units Medicare Defined
Swing Bed Unit
Medicare Defined
Swing Bed Unit 275N00000X 01 Inpatient Facility 010 Acute Care Y Y
Non-individual Hospitals Chronic Disease
Hospital
Chronic Disease
Hospital 281P00000X 01 Inpatient Facility 010 Acute Care Y Y
Non-individual Hospitals Chronic Disease
Hospital Children 281PC2000X 01 Inpatient Facility 010 Acute Care Y Y
Non-individual Hospitals Long Term Care
Hospital
Long Term Care
Hospital 282E00000X 01 Inpatient Facility 010 Acute Care Y Y
Non-individual Hospitals General Acute
Care Hospital
General Acute Care
Hospital 282N00000X 01 Inpatient Facility 010 Acute Care Y Y
Non-individual Hospitals General Acute
Care Hospital Women 282NW0100X 01 Inpatient Facility 010 Acute Care Y Y
Non-individual Hospitals Special Hospital Special Hospital 284300000X 01 Inpatient Facility 010 Acute Care Y Y
Non-individual Hospitals Military Hospital Military Hospital 286500000X 01 Inpatient Facility 010 Acute Care Y Y
Non-individual Hospitals Military Hospital Community
Health^^^^2865C1500X 01 Inpatient Facility 010 Acute Care Y Y
Non-individual Hospitals Military Hospital Military General
Acute Care Hospital 2865M2000X 01 Inpatient Facility 010 Acute Care Y Y
Non-individual Hospitals Military Hospital
Military General
Acute Care Hospital.
Operational
(Transportable)
2865X1600X 01 Inpatient Facility 010 Acute Care Y Y
Non-individual Hospitals Christian Science
Sanitorium
Christian Science
Sanitorium 287300000X 01 Inpatient Facility 010 Acute Care Y Y
Non-individual Hospital Units Psychiatric Unit Psychiatric Unit 273R00000X 01 Inpatient Facility 011 Psychiatric Y Y
Non-individual Hospitals Psychiatric
Hospital Psychiatric Hospital 283Q00000X 01 Inpatient Facility 011 Psychiatric Y Y
Non-individual Hospital Units Rehabilitation
Unit Rehabilitation Unit 273Y00000X 01 Inpatient Facility 012 Rehabilitation Y Y
Non-individual Hospital Units
Rehabilitation,
Substance Use
Disorder Unit
Rehabilitation,
Substance Use
Disorder Unit
276400000X 01 Inpatient Facility 012 Rehabilitation Y Y
Non-individual Hospitals Rehabilitation
Hospital
Rehabilitation
Hospital 283X00000X 01 Inpatient Facility 012 Rehabilitation Y Y
Non-individual Hospitals Rehabilitation
Hospital Children 283XC2000X 01 Inpatient Facility 012 Rehabilitation Y Y
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Non-individual
Residential
Treatment
Facilities
Psychiatric
Residential
Treatment Facility
Psychiatric
Residential
Treatment Facility
323P00000X 01 Inpatient Facility 013Residential Treatment
CenterN Y
Non-individual
Residential
Treatment
Facilities
Psychiatric
Residential
Treatment Facility
Psychiatric
Residential
Treatment Facility
323P00000X 01 Inpatient Facility 013Residential Treatment
CenterN Y
Non-individual Hospitals General Acute
Care Hospital
General Acute Care
Hospital 282N00000X 01 Inpatient Facility 014 Critical Access Y Y
Non-individual Hospitals General Acute
Care Hospital Critical Access 282NC0060X 01 Inpatient Facility 014 Critical Access Y Y
Non-individual Hospitals General Acute
Care Hospital Children 282NC2000X 01 Inpatient Facility 015 Children's Specialty Y Y
Non-individual Hospitals General Acute
Care Hospital
General Acute Care
Hospital 282N00000X 01 Inpatient Facility 016 Emergency N Y
Non-individual Hospitals General Acute
Care Hospital Rural 282NR1301X 01 Inpatient Facility 017 Acute Care - Rural Y Y
Non-individual Hospitals General Acute
Care Hospital Rural 282NR1301X 01 Inpatient Facility 017 Acute Care - Rural Y Y
Non-individual Hospitals Psychiatric
Hospital Psychiatric Hospital 283Q00000X 01 Inpatient Facility 018
Mental Health Inpatient
Hospitals Under 21N Y
Non-individual Hospitals Psychiatric
Hospital
Psychiatric
Hospital 283Q00000X 01 Inpatient Facility 018
Mental Health
Inpatient Hospitals
Under 21
N Y
Non-individual Hospitals Psychiatric
Hospital
Psychiatric
Hospital 283Q00000X 01 Inpatient Facility 019
Mental Health
Inpatient Hospitals
Over 65
Y Y
Non-individual Hospitals Hospital
Religious
Nonmedical Health
Care Institution
282J00000X 01 Inpatient Facility 682Religious Nonmedical
Health Care InstitutionN N
Non-individual
Ambulatory
Health Care
Facilities
Clinic/Center
Military and U.S.
Coast Guard
Ambulatory
Procedure
261QM1101X 02Ambulatory Surgical
Center (ASC)020
Ambulatory Surgical
Center (ASC)Y Y
Non-individual
Ambulatory
Health Care
Facilities
Clinic/Center
Oral and
Maxillofacial
Surgery
261QS0112X 02Ambulatory Surgical
Center (ASC)020
Ambulatory Surgical
Center (ASC)Y Y
Non-individual
Ambulatory
Health Care
Facilities
Clinic/Center Ophthalmologic
Surgery 261QS0132X 02
Ambulatory Surgical
Center (ASC)020
Ambulatory Surgical
Center (ASC)Y Y
Non-individual
Ambulatory
Health Care
Facilities
Clinic/Center Ambulatory Surgery 261QA1903X 02Ambulatory Surgical
Center (ASC)675
Ambulatory Surgical
Center (ASC)Y Y
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Non-individual
Nursing &
Custodial Care
Facilities
Intermediate Care
Facility, Mental
Illness
Intermediate Care
Facility, Mental
Illness
310500000X 03 Extended Care Facility 030 Nursing Facility - ICF Y Y
Non-individual
Nursing &
Custodial Care
Facilities
Nursing
Facility/Intermedi
ate Care Facility
Nursing
Facility/Intermediate
Care Facility
313M00000X 03 Extended Care Facility 030 Nursing Facility - ICF Y Y
Non-individual
Nursing &
Custodial Care
Facilities
Intermediate Care
Facility, Mentally
Retarded
Intermediate Care
Facility, Mentally
Retarded
315P00000X 03 Extended Care Facility 031 ICF/MR N Y
Non-individual
Nursing &
Custodial Care
Facilities
Nursing
Facility/Intermedi
ate Care Facility
Nursing
Facility/Intermediate
Care Facility
313M00000X 03 Extended Care Facility 032Pediatric Nursing
FacilityN Y
Non-individual
Nursing &
Custodial Care
Facilities
Skilled Nursing
Facility
Skilled Nursing
Facility 314000000X 03 Extended Care Facility 033
Residential Care
Facility N Y
Non-individual
Nursing &
Custodial Care
Facilities
Skilled Nursing
Facility
Skilled Nursing
Facility 314000000X 03 Extended Care Facility 034
Skilled Nursing Facility
(SNF) - OtherN Y
Non-individual
Nursing &
Custodial Care
Facilities
Alzheimer Center
(Dementia Center)
Alzheimer Center
(Dementia Center) 311500000X 03 Extended Care Facility 035
Skilled Nursing Facility
(SNF)Y Y
Non-individual
Nursing &
Custodial Care
Facilities
Skilled Nursing
Facility
Skilled Nursing
Facility 314000000X 03 Extended Care Facility 035
Skilled Nursing Facility
(SNF) Y Y
Non-individual
Nursing &
Custodial Care
Facilities
Skilled Nursing
Facility
Nursing Care,
Pediatric 3140N1450X 03 Extended Care Facility 035
Skilled Nursing Facility
(SNF) Y Y
Non-individual
Nursing &
Custodial Care
Facilities
Christian Science
Facility
Christian Science
Facility 317400000X 03 Extended Care Facility 035
Skilled Nursing Facility
(SNF) Y Y
Non-individual
Nursing &
Custodial Care
Facilities
Skilled Nursing
Facility
Skilled Nursing
Facility 314000000X 03 Extended Care Facility 036
Respite Care - Facility
Based N Y
Non-individual Respite Care
FacilityRespite Care Respite Care 385H00000X 03 Extended Care Facility 036
Respite Care - Facility
Based N Y
Non-individual Respite Care
FacilityRespite Care Respite Care Camp 385HR2050X 03 Extended Care Facility 036
Respite Care - Facility
Based N Y
Non-individual Respite Care
FacilityRespite Care
Respite Care, Mental
Illness, Child 385HR2055X 03 Extended Care Facility 036
Respite Care - Facility
Based N Y
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Non-individual Respite Care
FacilityRespite Care
Respite Care, Mental
Retardation and/or
Developmental
Disabilities
385HR2060X 03 Extended Care Facility 036Respite Care - Facility
Based N Y
Non-individual Respite Care
FacilityRespite Care
Respite Care,
Physical Disabilities,
Child
385HR2065X 03 Extended Care Facility 036Respite Care - Facility
Based N Y
Non-individual
Nursing &
Custodial Care
Facilities
Assisted Living
Facility
Assisted Living
Facility 310400000X 03 Extended Care Facility 037 Assisted Living N N
Non-individual
Nursing &
Custodial Care
Facilities
Assisted Living
Facility
Assisted Living,
Mental Illness 3104A0625X 03 Extended Care Facility 037 Assisted Living N N
Non-individual
Nursing &
Custodial Care
Facilities
Assisted Living
Facility
Assisted Living,
Behavioral
Disturbances
3104A0630X 03 Extended Care Facility 037 Assisted Living N N
Non-individual
Nursing &
Custodial Care
Facilities
Custodial Care
Facility
Custodial Care
Facility 311Z00000X 03 Extended Care Facility 037 Assisted Living N N
Non-individual
Nursing &
Custodial Care
Facilities
Custodial Care
Facility Adult Care Home 311ZA0620X 03 Extended Care Facility 037 Assisted Living N N
Non-individual
Nursing &
Custodial Care
Facilities
Intermediate Care
Facility, Mentally
Retarded
Intermediate Care
Facility, Mentally
Retarded
315P00000X 03 Extended Care Facility 038 ICF/MR - Other N Y
Non-individual
Nursing &
Custodial Care
Facilities
Nursing
Facility/Intermedi
ate Care Facility
Nursing
Facility/Intermediate
Care Facility
313M00000X 03 Extended Care Facility 039Nursing Facility - ICF -
OtherN Y
Non-individual
Ambulatory
Health Care
Facilities
Clinic/Center Rehabilitation 261QR0400X 04 Rehabilitation Facility 040 Rehabilitation Facility Y Y
Non-individual
Ambulatory
Health Care
Facilities
Clinic/Center
Rehabilitation,
Comprehensive
Outpatient
Rehabilitation
Facility (CORF)
261QR0401X 04 Rehabilitation Facility 040 Rehabilitation Facility Y Y
Non-individual
Ambulatory
Health Care
Facilities
Clinic/Center Rehabilitation,
Cardiac Facilities 261QR0404X 04 Rehabilitation Facility 040 Rehabilitation Facility Y Y
Non-individual
Ambulatory
Health Care
Facilities
Clinic/Center
Rehabilitation,
Substance Use
Disorder
261QR0405X 04 Rehabilitation Facility 040 Rehabilitation Facility Y Y
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Non-individual
Residential
Treatment
Facilities
Residential
Treatment
Facility, Mental
Retardation and/or
Developmental
Disabilities
Residential
Treatment Facility,
Mental Retardation
and/or
Developmental
Disabilities
320600000X 04 Rehabilitation Facility 040 Rehabilitation Facility Y Y
Non-individual
Residential
Treatment
Facilities
Residential
Treatment
Facility, Physical
Disabilities
Residential
Treatment Facility,
Physical Disabilities
320700000X 04 Rehabilitation Facility 040 Rehabilitation Facility Y Y
Non-individual
Residential
Treatment
Facilities
Community Based
Residential
Treatment
Facility, Mental
Illness
Community Based
Residential
Treatment Facility,
Mental Illness
320800000X 04 Rehabilitation Facility 040 Rehabilitation Facility Y Y
Non-individual
Residential
Treatment
Facilities
Community Based
Residential
Treatment
Facility, Mental
Retardation and/or
Developmental
Disabilities
Community Based
Residential
Treatment Facility,
Mental Retardation
and/or
Developmental
Disabilities
320900000X 04 Rehabilitation Facility 040 Rehabilitation Facility Y Y
Non-individual
Residential
Treatment
Facilities
Substance Abuse
Rehabilitation
Facility
Substance Abuse
Rehabilitation
Facility
324500000X 04 Rehabilitation Facility 040 Rehabilitation Facility Y Y
Non-individual
Residential
Treatment
Facilities
Substance Abuse
Rehabilitation
Facility
Substance Abuse
Treatment, Children 3245S0500X 04 Rehabilitation Facility 040 Rehabilitation Facility Y Y
Non-individual Agencies Home Health Home Health 251E00000X 05 Home Health Agency 050 Home Health Agency Y Y
Non-individual Agencies Home Health Home Health 251E00000X 05 Home Health Agency 051Specialized Home
Nursing ServicesN Y
Non-individual Agencies Voluntary or
Charitable
Voluntary or
Charitable 251V00000X 05 Home Health Agency 052 Voluntary or Charitable N Y
Non-individual Agencies Home Health Home Health 251E00000X 05 Home Health Agency 210Care Coordinator for
Pregnant WomenN Y
Non-individual Agencies Home Health Home Health 251E00000X 05 Home Health Agency 211 HIV Case Manager N Y
Non-individual Agencies Home Infusion Home Infusion 251F00000X 05 Home Health Agency 998Specialty not yet
definedN N
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Non-individual Agencies Hospice Care,
Community Based
Hospice Care,
Community Based 251G00000X 06 Hospice 060 Hospice Y Y
Non-individual
Nursing &
Custodial Care
Facilities
Hospice, Inpatient Hospice, Inpatient 315D00000X 06 Hospice 060 Hospice Y Y
Non-individual Managed Care
Organizations
Health
Maintenance
Organization
Health Maintenance
Organization 302R00000X 07 Capitation Provider 071
Manager Care
Organization (MCO)N Y
Non-individual Managed Care
Organizations
Preferred Provider
Organization
Preferred Provider
Organization 305R00000X 07 Capitation Provider 071
Manager Care
Organization (MCO)N Y
Non-individual Managed Care
OrganizationsPoint of Service Point of Service 305S00000X 07 Capitation Provider 071
Manager Care
Organization (MCO)N Y
Non-individual Agencies
Program of All-
Inclusive Care for
the Elderly
(PACE) Provider
Organization
Program of All-
Inclusive Care for
the Elderly (PACE)
Provider
Organization
251T00000X 07 Capitation Provider 071Manager Care
Organization (MCO)N Y
Non-individual Managed Care
Organizations
Health
Maintenance
Organization
Health Maintenance
Organization 302R00000X 07 Capitation Provider 072
Behavioral Health
Organization (BHO)N Y
Non-individual Managed Care
Organizations
Health
Maintenance
Organization
Health Maintenance
Organization 302R00000X 07 Capitation Provider 073
Dental Benefit Manager
(DBM)N Y
Non-individual Managed Care
Organizations
Health
Maintenance
Organization
Health Maintenance
Organization 302R00000X 07 Capitation Provider 074
Prescription Benefit
Manager (PBM)N Y
Non-individual
Ambulatory
Health Care
Facilities
Clinic/Center Student Health 261QS1000X 07 Capitation Provider 120 Teaching Institute N N
Non-individual
Ambulatory
Health Care
Facilities
Clinic/Center
Federally Qualified
Health Center
(FQHC)
261QF0400X 08 Clinic 080Federally Qualified
Health Clinic (FQHC)Y Y
Non-individual
Ambulatory
Health Care
Facilities
Clinic/Center Rural Health 261QR1300X 08 Clinic 081Rural Health Clinic
(RHC)Y Y
Non-individual
Ambulatory
Health Care
Facilities
Clinic/Center Clinic/Center 261Q00000X 08 Clinic 082 Medical Clinic Y Y
Non-individual
Ambulatory
Health Care
Facilities
Clinic/Center Amputee 261QA0900X 08 Clinic 082 Medical Clinic Y Y
Non-individual
Ambulatory
Health Care
Facilities
Clinic/Center Augmentative
Communication 261QA3000X 08 Clinic 082 Medical Clinic Y Y
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Non-individual
Ambulatory
Health Care
Facilities
Clinic/Center Critical Access
Hospital 261QC0050X 08 Clinic 082 Medical Clinic Y Y
Non-individual
Ambulatory
Health Care
Facilities
Clinic/Center Developmental
Disabilities 261QD1600X 08 Clinic 082 Medical Clinic Y Y
Non-individual
Ambulatory
Health Care
Facilities
Clinic/Center Emergency Care 261QE0002X 08 Clinic 082 Medical Clinic Y Y
Non-individual
Ambulatory
Health Care
Facilities
Clinic/Center Endoscopy 261QE0800X 08 Clinic 082 Medical Clinic Y Y
Non-individual
Ambulatory
Health Care
Facilities
Clinic/Center Genetics 261QG0250X 08 Clinic 082 Medical Clinic Y Y
Non-individual
Ambulatory
Health Care
Facilities
Clinic/Center Lithotripsy 261QL0400X 08 Clinic 082 Medical Clinic Y Y
Non-individual
Ambulatory
Health Care
Facilities
Clinic/Center Migrant Health 261QM1000X 08 Clinic 082 Medical Clinic Y Y
Non-individual
Ambulatory
Health Care
Facilities
Clinic/Center Military/U.S. Coast
Guard Outpatient 261QM1100X 08 Clinic 082 Medical Clinic Y Y
Non-individual
Ambulatory
Health Care
Facilities
Clinic/Center
Military Outpatient
Operational
(Transportable)
Component
261QM1102X 08 Clinic 082 Medical Clinic Y Y
Non-individual
Ambulatory
Health Care
Facilities
Clinic/Center
Military Ambulatory
Procedure Visits
Operational
(Transportable)
261QM1103X 08 Clinic 082 Medical Clinic Y Y
Non-individual
Ambulatory
Health Care
Facilities
Clinic/Center Magnetic Resonance
Imaging (MRI) 261QM1200X 08 Clinic 082 Medical Clinic Y Y
Non-individual
Ambulatory
Health Care
Facilities
Clinic/Center Multi-Specialty 261QM1300X 08 Clinic 082 Medical Clinic Y Y
Non-individual
Ambulatory
Health Care
Facilities
Clinic/Center Medical Specialty 261QM2500X 08 Clinic 082 Medical Clinic Y Y
Non-individual
Ambulatory
Health Care
Facilities
Clinic/Center Methadone 261QM2800X 08 Clinic 082 Medical Clinic Y Y
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Non-individual
Ambulatory
Health Care
Facilities
Clinic/Center Podiatric 261QP1100X 08 Clinic 082 Medical Clinic Y Y
Non-individual
Ambulatory
Health Care
Facilities
Clinic/Center Primary Care 261QP2300X 08 Clinic 082 Medical Clinic Y Y
Non-individual
Ambulatory
Health Care
Facilities
Clinic/Center Prison Health 261QP2400X 08 Clinic 082 Medical Clinic Y Y
Non-individual
Ambulatory
Health Care
Facilities
Clinic/Center Pain 261QP3300X 08 Clinic 082 Medical Clinic Y Y
Non-individual
Ambulatory
Health Care
Facilities
Clinic/Center Recovery Care 261QR0800X 08 Clinic 082 Medical Clinic Y Y
Non-individual
Ambulatory
Health Care
Facilities
Clinic/Center Research 261QR1100X 08 Clinic 082 Medical Clinic Y Y
Non-individual
Ambulatory
Health Care
Facilities
Clinic/Center Sleep Disorder
Diagnostic 261QS1200X 08 Clinic 082 Medical Clinic Y Y
Non-individual
Ambulatory
Health Care
Facilities
Clinic/Center Urgent Care 261QU0200X 08 Clinic 082 Medical Clinic Y Y
Non-individual
Ambulatory
Health Care
Facilities
Clinic/Center VA 261QV0200X 08 Clinic 082 Medical Clinic Y Y
Non-individual
Ambulatory
Health Care
Facilities
Clinic/Center Occupational
Medicine 261QX0100X 08 Clinic 082 Medical Clinic Y Y
Non-individual
Ambulatory
Health Care
Facilities
Clinic/Center Oncology 261QX0200X 08 Clinic 082 Medical Clinic Y Y
Non-individual
Ambulatory
Health Care
Facilities
Clinic/Center Oncology, Radiation 261QX0203X 08 Clinic 082 Medical Clinic Y Y
Non-individual
Ambulatory
Health Care
Facilities
Clinic/Center Ambulatory Family
Planning Facility 261QA0005X 08 Clinic 083 Family Planning Clinic Y Y
Non-individual
Ambulatory
Health Care
Facilities
Clinic/Center Ambulatory Fertility
Facility 261QA0006X 08 Clinic 083 Family Planning Clinic Y Y
Non-individual
Ambulatory
Health Care
Facilities
Clinic/Center Family Planning,
Non-Surgical 261QF0050X 08 Clinic 083 Family Planning Clinic Y Y
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Non-individual
Ambulatory
Health Care
Facilities
Clinic/Center Public Health, State
or Local 261QP0905X 08 Clinic 083 Family Planning Clinic Y Y
Individual or
Groups (of
Individuals)
Physician
Assistants &
Advanced
Practice Nursing
Providers
Nurse Practitioner Nurse Practitioner 363L00000X 08 Clinic 084Nurse Practitioner
ClinicN Y
Non-individual
Ambulatory
Health Care
Facilities
Clinic/Center Public Health,
Federal 261QP0904X 08 Clinic 085 EPSDT Clinic N Y
Non-individual
Ambulatory
Health Care
Facilities
Clinic/Center Dental 261QD0000X 08 Clinic 086 Dental Clinic Y Y
Non-individual
Ambulatory
Health Care
Facilities
Clinic/Center Infusion Therapy 261QI0500X 08 Clinic 087 Therapy Clinic Y Y
Non-individual
Ambulatory
Health Care
Facilities
Clinic/Center Physical Therapy 261QP2000X 08 Clinic 087 Therapy Clinic Y Y
Non-individual
Ambulatory
Health Care
Facilities
Clinic/Center Health Service 261QH0100X 08 Clinic 088 Pediatric Clinic N Y
Non-individual
Ambulatory
Health Care
Facilities
Clinic/Center
Adolescent and
Children Mental
Health
261QM0855X 08 Clinic 088 Pediatric Clinic N Y
Non-individual
Ambulatory
Health Care
Facilities
Clinic/Center
Medically Fragile
Infants and Children
Day Care
261QM3000X 08 Clinic 088 Pediatric Clinic N Y
Non-individual
Ambulatory
Health Care
Facilities
Clinic/Center Health Service 261QH0100X 08 Clinic 089 Tuberculosis Clinic N Y
Non-individual
Ambulatory
Health Care
Facilities
Clinic/Center Health Service 261QH0100X 08 Clinic 181 Maternity N Y
Non-individual
Ambulatory
Health Care
Facilities
Clinic/Center Health Service 261QH0100X 08 Clinic 182 Speech/Hearing Clinic N Y
Non-individual
Ambulatory
Health Care
Facilities
Clinic/Center Hearing and Speech 261QH0700X 08 Clinic 182 Speech/Hearing Clinic N Y
Non-individual
Ambulatory
Health Care
Facilities
Clinic/Center Health Service 261QH0100X 08 Clinic 183Early Intervention
ServicesN Y
Non-individual
Ambulatory
Health Care
Facilities
Clinic/Center Rural Health 261QR1300X 08 Clinic 184Hospital Based Rural
Health ClinicN Y
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Non-individual
Ambulatory
Health Care
Facilities
Clinic/Center Rural Health 261QR1300X 08 Clinic 185Free Standing Rural
Health ClinicY Y
Non-individual
Ambulatory
Health Care
Facilities
Clinic/Center Community Health 261QC1500X 08 Clinic 186 Community Health Y Y
Non-individual
Ambulatory
Health Care
Facilities
Clinic/Center Corporate Health 261QC1800X 08 Clinic 186 Community Health Y Y
Individual or
Groups (of
Individuals)
Physician
Assistants &
Advanced
Practice Nursing
Providers
Nurse Practitioner Pediatrics 363LP0200X 09 Advance Practice Nurse 090Pediatric Nurse
PractitionerN Y
Individual or
Groups (of
Individuals)
Physician
Assistants &
Advanced
Practice Nursing
Providers
Nurse Practitioner Pediatrics, Critical
Care 363LP0222X 09 Advance Practice Nurse 090
Pediatric Nurse
PractitionerN Y
Individual or
Groups (of
Individuals)
Physician
Assistants &
Advanced
Practice Nursing
Providers
Clinical Nurse
Specialist Pediatrics 364SP0200X 09 Advance Practice Nurse 090
Pediatric Nurse
PractitionerN Y
Individual or
Groups (of
Individuals)
Physician
Assistants &
Advanced
Practice Nursing
Providers
Nurse Practitioner Obstetrics &
Gynecology 363LX0001X 09 Advance Practice Nurse 091
Obstetric Nurse
PractitionerN Y
Individual or
Groups (of
Individuals)
Physician
Assistants &
Advanced
Practice Nursing
Providers
Nurse Practitioner Family 363LF0000X 09 Advance Practice Nurse 092Family Nurse
PractitionerY Y
Individual or
Groups (of
Individuals)
Physician
Assistants &
Advanced
Practice Nursing
Providers
Nurse Practitioner Nurse Practitioner 363L00000X 09 Advance Practice Nurse 093Nurse Practitioner
(Other)Y Y
Individual or
Groups (of
Individuals)
Physician
Assistants &
Advanced
Practice Nursing
Providers
Nurse Practitioner Acute Care 363LA2100X 09 Advance Practice Nurse 093Nurse Practitioner
(Other)Y Y
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Individual or
Groups (of
Individuals)
Physician
Assistants &
Advanced
Practice Nursing
Providers
Nurse Practitioner Adult Health 363LA2200X 09 Advance Practice Nurse 093Nurse Practitioner
(Other)Y Y
Individual or
Groups (of
Individuals)
Physician
Assistants &
Advanced
Practice Nursing
Providers
Nurse Practitioner Critical Care
Medicine 363LC0200X 09 Advance Practice Nurse 093
Nurse Practitioner
(Other)Y Y
Individual or
Groups (of
Individuals)
Physician
Assistants &
Advanced
Practice Nursing
Providers
Nurse Practitioner Community Health 363LC1500X 09 Advance Practice Nurse 093Nurse Practitioner
(Other)Y Y
Individual or
Groups (of
Individuals)
Physician
Assistants &
Advanced
Practice Nursing
Providers
Nurse Practitioner Gerontology 363LG0600X 09 Advance Practice Nurse 093Nurse Practitioner
(Other)Y Y
Individual or
Groups (of
Individuals)
Physician
Assistants &
Advanced
Practice Nursing
Providers
Nurse Practitioner Neonatal 363LN0000X 09 Advance Practice Nurse 093Nurse Practitioner
(Other)Y Y
Individual or
Groups (of
Individuals)
Physician
Assistants &
Advanced
Practice Nursing
Providers
Nurse Practitioner Neonatal, Critical
Care 363LN0005X 09 Advance Practice Nurse 093
Nurse Practitioner
(Other)Y Y
Individual or
Groups (of
Individuals)
Physician
Assistants &
Advanced
Practice Nursing
Providers
Nurse Practitioner Psychiatric/Mental
Health 363LP0808X 09 Advance Practice Nurse 093
Nurse Practitioner
(Other)Y Y
Individual or
Groups (of
Individuals)
Physician
Assistants &
Advanced
Practice Nursing
Providers
Nurse Practitioner Perinatal 363LP1700X 09 Advance Practice Nurse 093Nurse Practitioner
(Other)Y Y
Individual or
Groups (of
Individuals)
Physician
Assistants &
Advanced
Practice Nursing
Providers
Nurse Practitioner Primary Care 363LP2300X 09 Advance Practice Nurse 093Nurse Practitioner
(Other)Y Y
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Individual or
Groups (of
Individuals)
Physician
Assistants &
Advanced
Practice Nursing
Providers
Nurse Practitioner School 363LS0200X 09 Advance Practice Nurse 093Nurse Practitioner
(Other)Y Y
Individual or
Groups (of
Individuals)
Physician
Assistants &
Advanced
Practice Nursing
Providers
Nurse Practitioner Women's Health 363LW0102X 09 Advance Practice Nurse 093Nurse Practitioner
(Other)Y Y
Individual or
Groups (of
Individuals)
Physician
Assistants &
Advanced
Practice Nursing
Providers
Nurse Practitioner Occupational Health 363LX0106X 09 Advance Practice Nurse 093Nurse Practitioner
(Other)Y Y
Individual or
Groups (of
Individuals)
Physician
Assistants &
Advanced
Practice Nursing
Providers
Clinical Nurse
Specialist
Clinical Nurse
Specialist 364S00000X 09 Advance Practice Nurse 093
Nurse Practitioner
(Other)Y Y
Individual or
Groups (of
Individuals)
Physician
Assistants &
Advanced
Practice Nursing
Providers
Clinical Nurse
Specialist Acute Care 364SA2100X 09 Advance Practice Nurse 093
Nurse Practitioner
(Other)Y Y
Individual or
Groups (of
Individuals)
Physician
Assistants &
Advanced
Practice Nursing
Providers
Clinical Nurse
Specialist Adult Health 364SA2200X 09 Advance Practice Nurse 093
Nurse Practitioner
(Other)Y Y
Individual or
Groups (of
Individuals)
Physician
Assistants &
Advanced
Practice Nursing
Providers
Clinical Nurse
Specialist
Critical Care
Medicine 364SC0200X 09 Advance Practice Nurse 093
Nurse Practitioner
(Other)Y Y
Individual or
Groups (of
Individuals)
Physician
Assistants &
Advanced
Practice Nursing
Providers
Clinical Nurse
Specialist
Community
Health/Public Health 364SC1501X 09 Advance Practice Nurse 093
Nurse Practitioner
(Other)Y Y
Individual or
Groups (of
Individuals)
Physician
Assistants &
Advanced
Practice Nursing
Providers
Clinical Nurse
Specialist Chronic Care 364SC2300X 09 Advance Practice Nurse 093
Nurse Practitioner
(Other)Y Y
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Individual or
Groups (of
Individuals)
Physician
Assistants &
Advanced
Practice Nursing
Providers
Clinical Nurse
Specialist Emergency 364SE0003X 09 Advance Practice Nurse 093
Nurse Practitioner
(Other)Y Y
Individual or
Groups (of
Individuals)
Physician
Assistants &
Advanced
Practice Nursing
Providers
Clinical Nurse
Specialist Ethics 364SE1400X 09 Advance Practice Nurse 093
Nurse Practitioner
(Other)Y Y
Individual or
Groups (of
Individuals)
Physician
Assistants &
Advanced
Practice Nursing
Providers
Clinical Nurse
Specialist Family Health 364SF0001X 09 Advance Practice Nurse 093
Nurse Practitioner
(Other)Y Y
Individual or
Groups (of
Individuals)
Physician
Assistants &
Advanced
Practice Nursing
Providers
Clinical Nurse
Specialist Gerontology 364SG0600X 09 Advance Practice Nurse 093
Nurse Practitioner
(Other)Y Y
Individual or
Groups (of
Individuals)
Physician
Assistants &
Advanced
Practice Nursing
Providers
Clinical Nurse
Specialist Home Health 364SH0200X 09 Advance Practice Nurse 093
Nurse Practitioner
(Other)Y Y
Individual or
Groups (of
Individuals)
Physician
Assistants &
Advanced
Practice Nursing
Providers
Clinical Nurse
Specialist Holistic 364SH1100X 09 Advance Practice Nurse 093
Nurse Practitioner
(Other)Y Y
Individual or
Groups (of
Individuals)
Physician
Assistants &
Advanced
Practice Nursing
Providers
Clinical Nurse
Specialist Informatics 364SI0800X 09 Advance Practice Nurse 093
Nurse Practitioner
(Other)Y Y
Individual or
Groups (of
Individuals)
Physician
Assistants &
Advanced
Practice Nursing
Providers
Clinical Nurse
Specialist Long-Term Care 364SL0600X 09 Advance Practice Nurse 093
Nurse Practitioner
(Other)Y Y
Individual or
Groups (of
Individuals)
Physician
Assistants &
Advanced
Practice Nursing
Providers
Clinical Nurse
Specialist Medical-Surgical 364SM0705X 09 Advance Practice Nurse 093
Nurse Practitioner
(Other)Y Y
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Individual or
Groups (of
Individuals)
Physician
Assistants &
Advanced
Practice Nursing
Providers
Clinical Nurse
Specialist Neonatal 364SN0000X 09 Advance Practice Nurse 093
Nurse Practitioner
(Other)Y Y
Individual or
Groups (of
Individuals)
Physician
Assistants &
Advanced
Practice Nursing
Providers
Clinical Nurse
Specialist Neuroscience 364SN0800X 09 Advance Practice Nurse 093
Nurse Practitioner
(Other)Y Y
Individual or
Groups (of
Individuals)
Physician
Assistants &
Advanced
Practice Nursing
Providers
Clinical Nurse
Specialist
Psychiatric/Mental
Health, Child &
Adolescent
364SP0807X 09 Advance Practice Nurse 093Nurse Practitioner
(Other)Y Y
Individual or
Groups (of
Individuals)
Physician
Assistants &
Advanced
Practice Nursing
Providers
Clinical Nurse
Specialist
Psychiatric/Mental
Health 364SP0808X 09 Advance Practice Nurse 093
Nurse Practitioner
(Other)Y Y
Individual or
Groups (of
Individuals)
Physician
Assistants &
Advanced
Practice Nursing
Providers
Clinical Nurse
Specialist
Psychiatric/Mental
Health, Adult 364SP0809X 09 Advance Practice Nurse 093
Nurse Practitioner
(Other)Y Y
Individual or
Groups (of
Individuals)
Physician
Assistants &
Advanced
Practice Nursing
Providers
Clinical Nurse
Specialist
Psychiatric/Mental
Health, Child &
Family
364SP0810X 09 Advance Practice Nurse 093Nurse Practitioner
(Other)Y Y
Individual or
Groups (of
Individuals)
Physician
Assistants &
Advanced
Practice Nursing
Providers
Clinical Nurse
Specialist
Psychiatric/Mental
Health, Chronically
Ill
364SP0811X 09 Advance Practice Nurse 093Nurse Practitioner
(Other)Y Y
Individual or
Groups (of
Individuals)
Physician
Assistants &
Advanced
Practice Nursing
Providers
Clinical Nurse
Specialist
Psychiatric/Mental
Health, Community 364SP0812X 09 Advance Practice Nurse 093
Nurse Practitioner
(Other)Y Y
Individual or
Groups (of
Individuals)
Physician
Assistants &
Advanced
Practice Nursing
Providers
Clinical Nurse
Specialist
Psychiatric/Mental
Health,
Geropsychiatric
364SP0813X 09 Advance Practice Nurse 093Nurse Practitioner
(Other)Y Y
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Individual or
Groups (of
Individuals)
Physician
Assistants &
Advanced
Practice Nursing
Providers
Clinical Nurse
Specialist Perinatal 364SP1700X 09 Advance Practice Nurse 093
Nurse Practitioner
(Other)Y Y
Individual or
Groups (of
Individuals)
Physician
Assistants &
Advanced
Practice Nursing
Providers
Clinical Nurse
Specialist Perioperative 364SP2800X 09 Advance Practice Nurse 093
Nurse Practitioner
(Other)Y Y
Individual or
Groups (of
Individuals)
Physician
Assistants &
Advanced
Practice Nursing
Providers
Clinical Nurse
Specialist Rehabilitation 364SR0400X 09 Advance Practice Nurse 093
Nurse Practitioner
(Other)Y Y
Individual or
Groups (of
Individuals)
Physician
Assistants &
Advanced
Practice Nursing
Providers
Clinical Nurse
Specialist School 364SS0200X 09 Advance Practice Nurse 093
Nurse Practitioner
(Other)Y Y
Individual or
Groups (of
Individuals)
Physician
Assistants &
Advanced
Practice Nursing
Providers
Clinical Nurse
Specialist Transplantation 364ST0500X 09 Advance Practice Nurse 093
Nurse Practitioner
(Other)Y Y
Individual or
Groups (of
Individuals)
Physician
Assistants &
Advanced
Practice Nursing
Providers
Clinical Nurse
Specialist Women's Health 364SW0102X 09 Advance Practice Nurse 093
Nurse Practitioner
(Other)Y Y
Individual or
Groups (of
Individuals)
Physician
Assistants &
Advanced
Practice Nursing
Providers
Clinical Nurse
Specialist Occupational Health 364SX0106X 09 Advance Practice Nurse 093
Nurse Practitioner
(Other)Y Y
Individual or
Groups (of
Individuals)
Physician
Assistants &
Advanced
Practice Nursing
Providers
Clinical Nurse
Specialist Oncology 364SX0200X 09 Advance Practice Nurse 093
Nurse Practitioner
(Other)Y Y
Individual or
Groups (of
Individuals)
Physician
Assistants &
Advanced
Practice Nursing
Providers
Clinical Nurse
Specialist Oncology, Pediatrics 364SX0204X 09 Advance Practice Nurse 093
Nurse Practitioner
(Other)Y Y
Page 15 of 80
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Individual or
Groups (of
Individuals)
Physician
Assistants &
Advanced
Practice Nursing
Providers
Nurse Anesthetist,
Certified
Registered
Nurse Anesthetist,
Certified Registered 367500000X 09 Advance Practice Nurse 094
Certified Registered
Nurse Anesthetist
(CRNA)
Y Y
Individual or
Groups (of
Individuals)
Other Service
Providers
Midwife,
Certified Midwife, Certified 176B00000X 09 Advance Practice Nurse 095
Certified Nurse
MidwifeY Y
Individual or
Groups (of
Individuals)
Physician
Assistants &
Advanced
Practice Nursing
Providers
Midwife,
Certified Nurse
Midwife, Certified
Nurse 367A00000X 09 Advance Practice Nurse 095
Certified Nurse
MidwifeY Y
Individual or
Groups (of
Individuals)
Physician
Assistants &
Advanced
Practice Nursing
Providers
Nurse Practitioner Nurse Practitioner 363L00000X 09 Advance Practice Nurse 210Care Coordinator for
Pregnant WomenN Y
Individual or
Groups (of
Individuals)
Physician
Assistants &
Advanced
Practice Nursing
Providers
Nurse Practitioner Nurse Practitioner 363L00000X 09 Advance Practice Nurse 211 HIV Case Manager N Y
Individual or
Groups (of
Individuals)
Podiatric
Medicine &
Surgery Service
Providers
Assistant,
Podiatric Assistant, Podiatric 211D00000X 10 Mid-Level Practitioner 100 Physician Assistant N Y
Individual or
Groups (of
Individuals)
Physician
Assistants &
Advanced
Practice Nursing
Providers
Physician
Assistant Physician Assistant 363A00000X 10 Mid-Level Practitioner 100 Physician Assistant Y Y
Individual or
Groups (of
Individuals)
Physician
Assistants &
Advanced
Practice Nursing
Providers
Physician
Assistant Medical 363AM0700X 10 Mid-Level Practitioner 100 Physician Assistant Y Y
Individual or
Groups (of
Individuals)
Physician
Assistants &
Advanced
Practice Nursing
Providers
Physician
Assistant Surgical 363AS0400X 10 Mid-Level Practitioner 100 Physician Assistant Y Y
Individual or
Groups (of
Individuals)
Physician
Assistants &
Advanced
Practice Nursing
Providers
Nurse Anesthetist,
Certified
Registered
Nurse Anesthetist,
Certified Registered 367500000X 10 Mid-Level Practitioner 101
Anesthesiology
AssistantY Y
Page 16 of 80
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Individual or
Groups (of
Individuals)
Physician
Assistants &
Advanced
Practice Nursing
Providers
Anesthesiologist
Assistant
Anesthesiologist
Assistant 367H00000X 10 Mid-Level Practitioner 101
Anesthesiology
AssistantY Y
Non-individual
Ambulatory
Health Care
Facilities
Clinic/Center
Mental Health
(Including
Community Mental
Health Center)
261QM0801X 11 Mental Health Provider 110Outpatient Mental
Health ClinicY Y
Non-individual
Ambulatory
Health Care
Facilities
Clinic/Center
Mental Health
(Including
Community Mental
Health Center)
261QM0801X 11 Mental Health Provider 111Community Mental
Health Center (CMHC)Y Y
Non-individual
Ambulatory
Health Care
Facilities
Clinic/Center Adult Mental Health 261QM0850X 11 Mental Health Provider 111Community Mental
Health Center (CMHC)Y Y
Non-individual Agencies Community/Beha
vioral Health***&
Community/Behavio
ral Health***&251S00000X 11 Mental Health Provider 111
Community Mental
Health Center (CMHC)Y Y
Individual or
Groups (of
Individuals)
Behavioral Health
& Social Service
Providers
Psychoanalyst** Psychoanalyst** 102L00000X 11 Mental Health Provider 112 Psychologist Y Y
Individual or
Groups (of
Individuals)
Behavioral Health
& Social Service
Providers
Psychologist& Psychologist& 103T00000X 11 Mental Health Provider 112 Psychologist Y Y
Individual or
Groups (of
Individuals)
Behavioral Health
& Social Service
Providers
Psychologist&
Addiction
(Substance Use
Disorder)
103TA0400X 11 Mental Health Provider 112 Psychologist Y Y
Individual or
Groups (of
Individuals)
Behavioral Health
& Social Service
Providers
Psychologist&Adult Development
& Aging 103TA0700X 11 Mental Health Provider 112 Psychologist Y Y
Individual or
Groups (of
Individuals)
Behavioral Health
& Social Service
Providers
Psychologist&Cognitive &
Behavioral+ 103TB0200X 11 Mental Health Provider 112 Psychologist Y Y
Individual or
Groups (of
Individuals)
Behavioral Health
& Social Service
Providers
Psychologist& Counseling 103TC1900X 11 Mental Health Provider 112 Psychologist Y Y
Individual or
Groups (of
Individuals)
Behavioral Health
& Social Service
Providers
Psychologist& Educational^ 103TE1000X 11 Mental Health Provider 112 Psychologist Y Y
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Individual or
Groups (of
Individuals)
Behavioral Health
& Social Service
Providers
Psychologist& Exercise & Sports 103TE1100X 11 Mental Health Provider 112 Psychologist Y Y
Individual or
Groups (of
Individuals)
Behavioral Health
& Social Service
Providers
Psychologist& Family 103TF0000X 11 Mental Health Provider 112 Psychologist Y Y
Individual or
Groups (of
Individuals)
Behavioral Health
& Social Service
Providers
Psychologist& Forensic 103TF0200X 11 Mental Health Provider 112 Psychologist Y Y
Individual or
Groups (of
Individuals)
Behavioral Health
& Social Service
Providers
Psychologist& Health** 103TH0004X 11 Mental Health Provider 112 Psychologist Y Y
Individual or
Groups (of
Individuals)
Behavioral Health
& Social Service
Providers
Psychologist& Health Service 103TH0100X 11 Mental Health Provider 112 Psychologist Y Y
Individual or
Groups (of
Individuals)
Behavioral Health
& Social Service
Providers
Psychologist& Men & Masculinity^ 103TM1700X 11 Mental Health Provider 112 Psychologist Y Y
Individual or
Groups (of
Individuals)
Behavioral Health
& Social Service
Providers
Psychologist&
Mental Retardation
& Developmental
Disabilities
103TM1800X 11 Mental Health Provider 112 Psychologist Y Y
Individual or
Groups (of
Individuals)
Behavioral Health
& Social Service
Providers
Psychologist&Prescribing
(Medical)**103TP0016X 11 Mental Health Provider 112 Psychologist Y Y
Individual or
Groups (of
Individuals)
Behavioral Health
& Social Service
Providers
Psychologist& Psychoanalysis 103TP0814X 11 Mental Health Provider 112 Psychologist Y Y
Individual or
Groups (of
Individuals)
Behavioral Health
& Social Service
Providers
Psychologist& Psychotherapy^ 103TP2700X 11 Mental Health Provider 112 Psychologist Y Y
Individual or
Groups (of
Individuals)
Behavioral Health
& Social Service
Providers
Psychologist&Group
Psychotherapy+ 103TP2701X 11 Mental Health Provider 112 Psychologist Y Y
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Individual or
Groups (of
Individuals)
Behavioral Health
& Social Service
Providers
Psychologist& Rehabilitation 103TR0400X 11 Mental Health Provider 112 Psychologist Y Y
Individual or
Groups (of
Individuals)
Behavioral Health
& Social Service
Providers
Psychologist& School 103TS0200X 11 Mental Health Provider 112 Psychologist Y Y
Individual or
Groups (of
Individuals)
Behavioral Health
& Social Service
Providers
Psychologist& Women^ 103TW0100X 11 Mental Health Provider 112 Psychologist Y Y
Individual or
Groups (of
Individuals)
Behavioral Health
& Social Service
Providers
Clinical
Neuropsychologis
t+
Clinical
Neuropsychologist+ 103G00000X 11 Mental Health Provider 113 Clinical Psychologist Y Y
Individual or
Groups (of
Individuals)
Behavioral Health
& Social Service
Providers
Clinical
Neuropsychologis
t+
Clinical^ (use
103G00000X) 103GC0700X 11 Mental Health Provider 113 Clinical Psychologist Y Y
Individual or
Groups (of
Individuals)
Behavioral Health
& Social Service
Providers
Psychologist& Psychologist& 103T00000X 11 Mental Health Provider 113 Clinical Psychologist Y Y
Individual or
Groups (of
Individuals)
Behavioral Health
& Social Service
Providers
Psychologist& Clinical 103TC0700X 11 Mental Health Provider 113 Clinical Psychologist Y Y
Individual or
Groups (of
Individuals)
Behavioral Health
& Social Service
Providers
Psychologist&Clinical Child &
Adolescent+103TC2200X 11 Mental Health Provider 113 Clinical Psychologist Y Y
Individual or
Groups (of
Individuals)
Other Service
Providers
Sleep Specialist,
PhD
Sleep Specialist,
PhD*****173F00000X 11 Mental Health Provider 113 Clinical Psychologist Y N
Individual or
Groups (of
Individuals)
Behavioral Health
& Social Service
Providers
Psychologist& Psychologist& 103T00000X 11 Mental Health Provider 114Health Service Provider
in Psychology (HSPP)N Y
Individual or
Groups (of
Individuals)
Behavioral Health
& Social Service
Providers
Social Worker Clinical 1041C0700X 11 Mental Health Provider 115Certified Clinical
Social WorkerY Y
Individual or
Groups (of
Individuals)
Behavioral Health
& Social Service
Providers
Social Worker Social Worker 104100000X 11 Mental Health Provider 116 Certified Social Worker Y Y
Page 19 of 80
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Individual or
Groups (of
Individuals)
Behavioral Health
& Social Service
Providers
Social Worker School 1041S0200X 11 Mental Health Provider 116 Certified Social Worker Y Y
Individual or
Groups (of
Individuals)
Nursing Service
ProvidersRegistered Nurse
Psychiatric/Mental
Health 163WP0808X 11 Mental Health Provider 117 Psychiatric Nurse N Y
Non-individual
Ambulatory
Health Care
Facilities
Clinic/Center
Mental Health
(Including
Community Mental
Health Center)
261QM0801X 11 Mental Health Provider 118Mental Health -
DMHSASN Y
Individual or
Groups (of
Individuals)
Behavioral Health
& Social Service
Providers
Marriage &
Family Therapist
Marriage & Family
Therapist 106H00000X 11 Mental Health Provider 119
Marriage and Family
CounselorN Y
Individual or
Groups (of
Individuals)
Behavioral Health
& Social Service
Providers
Counselor Counselor 101Y00000X 11 Mental Health Provider 121Licensed Practical
CounselorN N
Individual or
Groups (of
Individuals)
Behavioral Health
& Social Service
Providers
Counselor Mental Health 101YM0800X 11 Mental Health Provider 121Licensed Practical
CounselorN N
Individual or
Groups (of
Individuals)
Behavioral Health
& Social Service
Providers
Counselor Pastoral 101YP1600X 11 Mental Health Provider 121Licensed Practical
CounselorN N
Individual or
Groups (of
Individuals)
Behavioral Health
& Social Service
Providers
Counselor Professional 101YP2500X 11 Mental Health Provider 121Licensed Practical
CounselorN N
Individual or
Groups (of
Individuals)
Behavioral Health
& Social Service
Providers
Counselor School 101YS0200X 11 Mental Health Provider 121Licensed Practical
CounselorN N
Individual or
Groups (of
Individuals)
Behavioral Health
& Social Service
Providers
Behavioral
Analyst
Classification
Behavioral Analyst
Classification103K00000X 11 Mental Health Provider 122 Behavioral Analyst N Y
Individual or
Groups (of
Individuals)
Behavioral Health
& Social Service
Providers
Assistant
Behavior AnalystBehavior Analyst 106E00000X 11 Mental Health Provider 122 Behavior Analyst N Y
Individual or
Groups (of
Individuals)
Behavioral Health
& Social Service
Providers
Behavior
TechnicianBehavior Technician 106S00000X 11 Mental Health Provider 122 Behavior Analyst N Y
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Non-individual
Ambulatory
Health Care
Facilities
Clinic/Center
Mental Health
(Including
Community Mental
Health Center)
261QM0801X 11 Mental Health Provider 210Care Coordinator for
Pregnant WomenN Y
Non-individual
Ambulatory
Health Care
Facilities
Clinic/Center
Mental Health
(Including
Community Mental
Health Center)
261QM0801X 11 Mental Health Provider 211 HIV Case Manager N Y
Individual or
Groups (of
Individuals)
Behavioral Health
& Social Service
Providers
Counselor
Addiction
(Substance Use
Disorder)
101YA0400X 11 Mental Health Provider 212 Addiction Counselor N Y
Individual or
Groups (of
Individuals)
Other Service
Providers
Genetic
Counselor, MS
Genetic Counselor,
MS 170300000X 11 Mental Health Provider 357 Genetics N N
Non-individual Agencies
Day Training,
Developmentally
Disabled Services
Day Training,
Developmentally
Disabled Services
251C00000X 11 Mental Health Provider 493DDSD-Supportive
Living ArrangementsN N
Individual or
Groups (of
Individuals)
Behavioral Health
& Social Service
Providers
Poetry TherapistPoetry
Therapist****102X00000X 11 Mental Health 617 Poetry Therapist N N
Non-individual Agencies Local Education
Agency (LEA)
Local Education
Agency (LEA) 251300000X 12 School Corporation 120 School Corporation Y N
Non-individual
Ambulatory
Health Care
Facilities
Clinic/Center Student Health 261QS1000X 12 School Corporation 120 Teaching Institute Y N
Non-individual Agencies Public Health or
Welfare
Public Health or
Welfare 251K00000X 13 Public Health Agency 130
County Health
DepartmentY N
Non-individual Agencies
Early
InterventionProvi
der Agency
Early Intervention
Provider
Agency****
252Y00000X 13 Public Health Agency 183Early Intervention
ServicesN N
Individual or
Groups (of
Individuals)
Podiatric
Medicine &
Surgery Service
Providers
Podiatrist Podiatrist 213E00000X 14 Podiatrist 140 Podiatrist Y Y
Individual or
Groups (of
Individuals)
Podiatric
Medicine &
Surgery Service
Providers
Podiatrist General Practice^^^
(use 213E00000X)213EG0000X 14 Podiatrist 140 Podiatrist Y Y
Individual or
Groups (of
Individuals)
Podiatric
Medicine &
Surgery Service
Providers
Podiatrist Public Medicine 213EP0504X 14 Podiatrist 140 Podiatrist Y Y
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Individual or
Groups (of
Individuals)
Podiatric
Medicine &
Surgery Service
Providers
Podiatrist Primary Podiatric
Medicine 213EP1101X 14 Podiatrist 140 Podiatrist Y Y
Individual or
Groups (of
Individuals)
Podiatric
Medicine &
Surgery Service
Providers
Podiatrist Radiology 213ER0200X 14 Podiatrist 140 Podiatrist Y Y
Individual or
Groups (of
Individuals)
Podiatric
Medicine &
Surgery Service
Providers
Podiatrist Sports Medicine 213ES0000X 14 Podiatrist 140 Podiatrist Y Y
Individual or
Groups (of
Individuals)
Podiatric
Medicine &
Surgery Service
Providers
Podiatrist Foot & Ankle
Surgery 213ES0103X 14 Podiatrist 140 Podiatrist Y Y
Individual or
Groups (of
Individuals)
Podiatric
Medicine &
Surgery Service
Providers
Podiatrist Foot Surgery 213ES0131X 14 Podiatrist 140 Podiatrist Y Y
Individual or
Groups (of
Individuals)
Chiropractic
ProvidersChiropractor Chiropractor 111N00000X 15 Chiropractor 150 Chiropractor Y Y
Individual or
Groups (of
Individuals)
Chiropractic
ProvidersChiropractor
Independent Medical
Examiner** 111NI0013X 15 Chiropractor 150 Chiropractor Y Y
Individual or
Groups (of
Individuals)
Chiropractic
ProvidersChiropractor Internist 111NI0900X 15 Chiropractor 150 Chiropractor Y Y
Individual or
Groups (of
Individuals)
Chiropractic
ProvidersChiropractor Neurology 111NN0400X 15 Chiropractor 150 Chiropractor Y Y
Individual or
Groups (of
Individuals)
Chiropractic
ProvidersChiropractor Nutrition 111NN1001X 15 Chiropractor 150 Chiropractor Y Y
Individual or
Groups (of
Individuals)
Chiropractic
ProvidersChiropractor Pediatric***** 111NP0017X 15 Chiropractor 150 Chiropractor Y N
Individual or
Groups (of
Individuals)
Chiropractic
ProvidersChiropractor Radiology 111NR0200X 15 Chiropractor 150 Chiropractor Y Y
Individual or
Groups (of
Individuals)
Chiropractic
ProvidersChiropractor Rehabilitation 111NR0400X 15 Chiropractor 150 Chiropractor Y Y
Individual or
Groups (of
Individuals)
Chiropractic
ProvidersChiropractor Sports Physician 111NS0005X 15 Chiropractor 150 Chiropractor Y Y
Page 22 of 80
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Individual or
Groups (of
Individuals)
Chiropractic
ProvidersChiropractor Thermography 111NT0100X 15 Chiropractor 150 Chiropractor Y Y
Individual or
Groups (of
Individuals)
Chiropractic
ProvidersChiropractor
Occupational
Medicine 111NX0100X 15 Chiropractor 150 Chiropractor Y Y
Individual or
Groups (of
Individuals)
Chiropractic
ProvidersChiropractor Orthopedic 111NX0800X 15 Chiropractor 150 Chiropractor Y Y
Individual or
Groups (of
Individuals)
Nursing Service
ProvidersRegistered Nurse
Psychiatric/Mental
Health, Child &
Adolescent
163WP0807X 16 Nurse 117 Psychiatric Nurse N N
Individual or
Groups (of
Individuals)
Nursing Service
ProvidersRegistered Nurse
Psychiatric/Mental
Health, Adult 163WP0809X 16 Nurse 117 Psychiatric Nurse N N
Individual or
Groups (of
Individuals)
Nursing Service
ProvidersRegistered Nurse Registered Nurse 163W00000X 16 Nurse 160 Registered Nurse (RN) N Y
Individual or
Groups (of
Individuals)
Nursing Service
Providers
Licensed Practical
Nurse
Licensed Practical
Nurse 164W00000X 16 Nurse 161
Licensed Practical
Nurse (LPN)N Y
Individual or
Groups (of
Individuals)
Nursing Service
Providers
Licensed
Vocational Nurse
Licensed Vocational
Nurse 164X00000X 16 Nurse 161
Licensed Practical
Nurse (LPN)N Y
Individual or
Groups (of
Individuals)
Nursing Service
ProvidersRegistered Nurse Registered Nurse 163W00000X 16 Nurse 162
Registered Nurse
Clinical (RNC)Y Y
Individual or
Groups (of
Individuals)
Nursing Service
ProvidersRegistered Nurse
Addiction
(Substance Use
Disorder)
163WA0400X 16 Nurse 162Registered Nurse
Clinical (RNC)Y Y
Individual or
Groups (of
Individuals)
Nursing Service
ProvidersRegistered Nurse Administrator 163WA2000X 16 Nurse 162
Registered Nurse
Clinical (RNC)Y Y
Individual or
Groups (of
Individuals)
Nursing Service
ProvidersRegistered Nurse
Critical Care
Medicine 163WC0200X 16 Nurse 162
Registered Nurse
Clinical (RNC)Y Y
Individual or
Groups (of
Individuals)
Nursing Service
ProvidersRegistered Nurse Case Management 163WC0400X 16 Nurse 162
Registered Nurse
Clinical (RNC)Y Y
Individual or
Groups (of
Individuals)
Nursing Service
ProvidersRegistered Nurse College Health 163WC1400X 16 Nurse 162
Registered Nurse
Clinical (RNC)Y Y
Individual or
Groups (of
Individuals)
Nursing Service
ProvidersRegistered Nurse Community Health 163WC1500X 16 Nurse 162
Registered Nurse
Clinical (RNC)Y Y
Page 23 of 80
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Individual or
Groups (of
Individuals)
Nursing Service
ProvidersRegistered Nurse
Continuing
Education/Staff
Development
163WC1600X 16 Nurse 162Registered Nurse
Clinical (RNC)Y Y
Individual or
Groups (of
Individuals)
Nursing Service
ProvidersRegistered Nurse Continence Care 163WC2100X 16 Nurse 162
Registered Nurse
Clinical (RNC)Y Y
Individual or
Groups (of
Individuals)
Nursing Service
ProvidersRegistered Nurse
Cardiac
Rehabilitation 163WC3500X 16 Nurse 162
Registered Nurse
Clinical (RNC)Y Y
Individual or
Groups (of
Individuals)
Nursing Service
ProvidersRegistered Nurse Diabetes Educator 163WD0400X 16 Nurse 162
Registered Nurse
Clinical (RNC)Y Y
Individual or
Groups (of
Individuals)
Nursing Service
ProvidersRegistered Nurse Dialysis, Peritoneal 163WD1100X 16 Nurse 162
Registered Nurse
Clinical (RNC)Y Y
Individual or
Groups (of
Individuals)
Nursing Service
ProvidersRegistered Nurse Emergency 163WE0003X 16 Nurse 162
Registered Nurse
Clinical (RNC)Y Y
Individual or
Groups (of
Individuals)
Nursing Service
ProvidersRegistered Nurse
Enterostomal
Therapy 163WE0900X 16 Nurse 162
Registered Nurse
Clinical (RNC)Y Y
Individual or
Groups (of
Individuals)
Nursing Service
ProvidersRegistered Nurse Flight 163WF0300X 16 Nurse 162
Registered Nurse
Clinical (RNC)Y Y
Individual or
Groups (of
Individuals)
Nursing Service
ProvidersRegistered Nurse General Practice 163WG0000X 16 Nurse 162
Registered Nurse
Clinical (RNC)Y Y
Individual or
Groups (of
Individuals)
Nursing Service
ProvidersRegistered Nurse Gastroenterology 163WG0100X 16 Nurse 162
Registered Nurse
Clinical (RNC)Y Y
Individual or
Groups (of
Individuals)
Nursing Service
ProvidersRegistered Nurse Gerontology 163WG0600X 16 Nurse 162
Registered Nurse
Clinical (RNC)Y Y
Individual or
Groups (of
Individuals)
Nursing Service
ProvidersRegistered Nurse Home Health 163WH0200X 16 Nurse 162
Registered Nurse
Clinical (RNC)Y Y
Individual or
Groups (of
Individuals)
Nursing Service
ProvidersRegistered Nurse Hemodialysis 163WH0500X 16 Nurse 162
Registered Nurse
Clinical (RNC)Y Y
Individual or
Groups (of
Individuals)
Nursing Service
ProvidersRegistered Nurse Hospice 163WH1000X 16 Nurse 162
Registered Nurse
Clinical (RNC)Y Y
Individual or
Groups (of
Individuals)
Nursing Service
ProvidersRegistered Nurse Infusion Therapy 163WI0500X 16 Nurse 162
Registered Nurse
Clinical (RNC)Y Y
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Individual or
Groups (of
Individuals)
Nursing Service
ProvidersRegistered Nurse Lactation Consultant 163WL0100X 16 Nurse 162
Registered Nurse
Clinical (RNC)Y Y
Individual or
Groups (of
Individuals)
Nursing Service
ProvidersRegistered Nurse Maternal Newborn 163WM0102X 16 Nurse 162
Registered Nurse
Clinical (RNC)Y Y
Individual or
Groups (of
Individuals)
Nursing Service
ProvidersRegistered Nurse Medical-Surgical 163WM0705X 16 Nurse 162
Registered Nurse
Clinical (RNC)Y Y
Individual or
Groups (of
Individuals)
Nursing Service
ProvidersRegistered Nurse
Nurse Massage
Therapist (NMT) 163WM1400X 16 Nurse 162
Registered Nurse
Clinical (RNC)Y Y
Individual or
Groups (of
Individuals)
Nursing Service
ProvidersRegistered Nurse
Neonatal Intensive
Care 163WN0002X 16 Nurse 162
Registered Nurse
Clinical (RNC)Y Y
Individual or
Groups (of
Individuals)
Nursing Service
ProvidersRegistered Nurse Neonatal, Low Risk 163WN0003X 16 Nurse 162
Registered Nurse
Clinical (RNC)Y Y
Individual or
Groups (of
Individuals)
Nursing Service
ProvidersRegistered Nurse Nephrology 163WN0300X 16 Nurse 162
Registered Nurse
Clinical (RNC)Y Y
Individual or
Groups (of
Individuals)
Nursing Service
ProvidersRegistered Nurse Neuroscience 163WN0800X 16 Nurse 162
Registered Nurse
Clinical (RNC)Y Y
Individual or
Groups (of
Individuals)
Nursing Service
ProvidersRegistered Nurse Nutrition Support 163WN1003X 16 Nurse 162
Registered Nurse
Clinical (RNC)Y Y
Individual or
Groups (of
Individuals)
Nursing Service
ProvidersRegistered Nurse Pain Management 163WP0000X 16 Nurse 162
Registered Nurse
Clinical (RNC)Y Y
Individual or
Groups (of
Individuals)
Nursing Service
ProvidersRegistered Nurse Pediatrics 163WP0200X 16 Nurse 162
Registered Nurse
Clinical (RNC)Y Y
Individual or
Groups (of
Individuals)
Nursing Service
ProvidersRegistered Nurse Pediatric Oncology 163WP0218X 16 Nurse 162
Registered Nurse
Clinical (RNC)Y Y
Individual or
Groups (of
Individuals)
Nursing Service
ProvidersRegistered Nurse Ambulatory Care 163WP2201X 16 Nurse 162
Registered Nurse
Clinical (RNC)Y Y
Individual or
Groups (of
Individuals)
Nursing Service
ProvidersRegistered Nurse
Registered Nurse
First Assistant 163WR0006X 16 Nurse 162
Registered Nurse
Clinical (RNC)Y Y
Individual or
Groups (of
Individuals)
Nursing Service
ProvidersRegistered Nurse Rehabilitation 163WR0400X 16 Nurse 162
Registered Nurse
Clinical (RNC)Y Y
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Individual or
Groups (of
Individuals)
Nursing Service
ProvidersRegistered Nurse
Reproductive
Endocrinology/Infert
ility
163WR1000X 16 Nurse 162Registered Nurse
Clinical (RNC)Y Y
Individual or
Groups (of
Individuals)
Nursing Service
ProvidersRegistered Nurse Plastic Surgery 163WS0121X 16 Nurse 162
Registered Nurse
Clinical (RNC)Y Y
Individual or
Groups (of
Individuals)
Nursing Service
ProvidersRegistered Nurse School 163WS0200X 16 Nurse 162
Registered Nurse
Clinical (RNC)Y Y
Individual or
Groups (of
Individuals)
Nursing Service
ProvidersRegistered Nurse Urology 163WU0100X 16 Nurse 162
Registered Nurse
Clinical (RNC)Y Y
Individual or
Groups (of
Individuals)
Nursing Service
ProvidersRegistered Nurse Wound Care 163WW0000X 16 Nurse 162
Registered Nurse
Clinical (RNC)Y Y
Individual or
Groups (of
Individuals)
Nursing Service
ProvidersRegistered Nurse
Women's Health
Care, Ambulatory 163WW0101X 16 Nurse 162
Registered Nurse
Clinical (RNC)Y Y
Individual or
Groups (of
Individuals)
Nursing Service
ProvidersRegistered Nurse Obstetric, High-Risk 163WX0002X 16 Nurse 162
Registered Nurse
Clinical (RNC)Y Y
Individual or
Groups (of
Individuals)
Nursing Service
ProvidersRegistered Nurse Obstetric, Inpatient 163WX0003X 16 Nurse 162
Registered Nurse
Clinical (RNC)Y Y
Individual or
Groups (of
Individuals)
Nursing Service
ProvidersRegistered Nurse Occupational Health 163WX0106X 16 Nurse 162
Registered Nurse
Clinical (RNC)Y Y
Individual or
Groups (of
Individuals)
Nursing Service
ProvidersRegistered Nurse Oncology 163WX0200X 16 Nurse 162
Registered Nurse
Clinical (RNC)Y Y
Individual or
Groups (of
Individuals)
Nursing Service
ProvidersRegistered Nurse
Otorhinolaryngology
& Head-Neck 163WX0601X 16 Nurse 162
Registered Nurse
Clinical (RNC)Y Y
Individual or
Groups (of
Individuals)
Nursing Service
ProvidersRegistered Nurse Orthopedic 163WX0800X 16 Nurse 162
Registered Nurse
Clinical (RNC)Y Y
Individual or
Groups (of
Individuals)
Nursing Service
ProvidersRegistered Nurse Ophthalmic 163WX1100X 16 Nurse 162
Registered Nurse
Clinical (RNC)Y Y
Individual or
Groups (of
Individuals)
Nursing Service
ProvidersRegistered Nurse Ostomy Care 163WX1500X 16 Nurse 162
Registered Nurse
Clinical (RNC)Y Y
Individual or
Groups (of
Individuals)
Nursing Service
Related Providers
Christian Science
Practitioner/Nurse
Christian Science
Practitioner/Nurse 374T00000X 16 Nurse 162
Registered Nurse
Clinical (RNC)Y Y
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Non-individual Agencies Nursing Care Nursing Care 251J00000X 16 Nurse 163 Skilled Nursing Agency N N
Individual or
Groups (of
Individuals)
Nursing Service
ProvidersRegistered Nurse Perinatal 163WP1700X 16 Nurse 210
Care Coordinator for
Pregnant WomenN Y
Individual or
Groups (of
Individuals)
Nursing Service
ProvidersRegistered Nurse Infection Control 163WI0600X 16 Nurse 211 HIV Case Manager N Y
Individual or
Groups (of
Individuals)
Other Service
ProvidersAcupuncturist Acupuncturist 171100000X 17 Therapist 170 Physical Therapist Y Y
Individual or
Groups (of
Individuals)
Other Service
Providers
Mechanotherapist
** Mechanotherapist** 172M00000X 17 Therapist 170 Physical Therapist Y Y
Individual or
Groups (of
Individuals)
Respiratory,
Developmental,
Rehabilitative and
Restorative
Service
Providers+&
Physical Therapist Physical Therapist 225100000X 17 Therapist 170 Physical Therapist Y Y
Individual or
Groups (of
Individuals)
Respiratory,
Developmental,
Rehabilitative and
Restorative
Service
Providers+&
Physical Therapist Cardiopulmonary 2251C2600X 17 Therapist 170 Physical Therapist Y Y
Individual or
Groups (of
Individuals)
Respiratory,
Developmental,
Rehabilitative and
Restorative
Service
Providers+&
Physical Therapist Ergonomics 2251E1200X 17 Therapist 170 Physical Therapist Y Y
Individual or
Groups (of
Individuals)
Respiratory,
Developmental,
Rehabilitative and
Restorative
Service
Providers+&
Physical Therapist Electrophysiology,
Clinical 2251E1300X 17 Therapist 170 Physical Therapist Y Y
Individual or
Groups (of
Individuals)
Respiratory,
Developmental,
Rehabilitative and
Restorative
Service
Providers+&
Physical Therapist Geriatrics 2251G0304X 17 Therapist 170 Physical Therapist Y Y
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Individual or
Groups (of
Individuals)
Respiratory,
Developmental,
Rehabilitative and
Restorative
Service
Providers+&
Physical Therapist Hand 2251H1200X 17 Therapist 170 Physical Therapist Y Y
Individual or
Groups (of
Individuals)
Respiratory,
Developmental,
Rehabilitative and
Restorative
Service
Providers+&
Physical Therapist Human Factors 2251H1300X 17 Therapist 170 Physical Therapist Y Y
Individual or
Groups (of
Individuals)
Respiratory,
Developmental,
Rehabilitative and
Restorative
Service
Providers+&
Physical Therapist Neurology 2251N0400X 17 Therapist 170 Physical Therapist Y Y
Individual or
Groups (of
Individuals)
Respiratory,
Developmental,
Rehabilitative and
Restorative
Service
Providers+&
Physical Therapist Pediatrics 2251P0200X 17 Therapist 170 Physical Therapist Y Y
Individual or
Groups (of
Individuals)
Respiratory,
Developmental,
Rehabilitative and
Restorative
Service
Providers+&
Physical Therapist Sports 2251S0007X 17 Therapist 170 Physical Therapist Y Y
Individual or
Groups (of
Individuals)
Respiratory,
Developmental,
Rehabilitative and
Restorative
Service
Providers+&
Physical Therapist Orthopedic 2251X0800X 17 Therapist 170 Physical Therapist Y Y
Individual or
Groups (of
Individuals)
Respiratory,
Developmental,
Rehabilitative and
Restorative
Service
Providers+&
Rehabilitation
Practitioner
Rehabilitation
Practitioner 225400000X 17 Therapist 170 Physical Therapist Y Y
Individual or
Groups (of
Individuals)
Other Service
ProvidersReflexologist Reflexologist***** 173C00000X 17 Therapist 170 Physical Therapist Y N
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Individual or
Groups (of
Individuals)
Respiratory,
Developmental,
Rehabilitative and
Restorative
Service
Providers+&
Occupational
Therapist
Occupational
Therapist 225X00000X 17 Therapist 171 Occupational Therapist Y Y
Individual or
Groups (of
Individuals)
Respiratory,
Developmental,
Rehabilitative and
Restorative
Service
Providers+&
Occupational
Therapist Ergonomics 225XE1200X 17 Therapist 171 Occupational Therapist Y Y
Individual or
Groups (of
Individuals)
Respiratory,
Developmental,
Rehabilitative and
Restorative
Service
Providers+&
Occupational
Therapist Hand 225XH1200X 17 Therapist 171 Occupational Therapist Y Y
Individual or
Groups (of
Individuals)
Respiratory,
Developmental,
Rehabilitative and
Restorative
Service
Providers+&
Occupational
Therapist Human Factors 225XH1300X 17 Therapist 171 Occupational Therapist Y Y
Individual or
Groups (of
Individuals)
Respiratory,
Developmental,
Rehabilitative and
Restorative
Service
Providers+&
Occupational
Therapist Neurorehabilitation 225XN1300X 17 Therapist 171 Occupational Therapist Y Y
Individual or
Groups (of
Individuals)
Respiratory,
Developmental,
Rehabilitative and
Restorative
Service
Providers+&
Occupational
Therapist Pediatrics 225XP0200X 17 Therapist 171 Occupational Therapist Y Y
Individual or
Groups (of
Individuals)
Respiratory,
Developmental,
Rehabilitative and
Restorative
Service
Providers+&
Occupational
Therapist
Rehabilitation,
Driver 225XR0403X 17 Therapist 171 Occupational Therapist Y Y
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Individual or
Groups (of
Individuals)
Respiratory,
Developmental,
Rehabilitative and
Restorative
Service Providers
Occupational
Therapist
Environmental
Modification
Specialization
225XE0001X 17 Therapist 171 Occupational Therapist Y Y
Individual or
Groups (of
Individuals)
Respiratory,
Developmental,
Rehabilitative and
Restorative
Service Providers
Restorative
Service Providers
Occupational
Therapist 225XF0002X 17 Therapist 171 Occupational Therapist Y Y
Individual or
Groups (of
Individuals)
Respiratory,
Developmental
Rehabilitative and
Restorative
Service Providers
Type,
Occupational
Therapist
Gerontology
Specialization225XG0600X 17 Therapist 171 Occupational Therapist Y Y
Individual or
Groups (of
Individuals)
Respiratory,
Developmental,
Rehabilitative and
Restorative
Service Providers
Occupational
Therapist
Low Vision
Specialization225XL0004X 17 Therapist 171 Occupational Therapist Y Y
Individual or
Groups (of
Individuals)
Respiratory,
Developmental,
Rehabilitative and
Restorative
Service Providers
Occupational
Therapist
Mental Health
Specialization225XM0800X 17 Therapist 171 Occupational Therapist Y Y
Individual or
Groups (of
Individuals)
Respiratory,
Developmental,
Rehabilitative and
Restorative
Service Providers
Occupational
Therapist
Physical
Rehabilitation 225XP0019X 17 Therapist 171 Occupational Therapist Y Y
Individual or
Groups (of
Individuals)
Respiratory,
Developmental,
Rehabilitative and
Restorative
Service
Providers+&
Respiratory
Therapist,
Certified
Respiratory
Therapist, Certified 227800000X 17 Therapist 172 Respiratory Therapist N Y
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Individual or
Groups (of
Individuals)
Respiratory,
Developmental,
Rehabilitative and
Restorative
Service
Providers+&
Respiratory
Therapist,
Certified
Critical Care 2278C0205X 17 Therapist 172 Respiratory Therapist N Y
Individual or
Groups (of
Individuals)
Respiratory,
Developmental,
Rehabilitative and
Restorative
Service
Providers+&
Respiratory
Therapist,
Certified
Emergency Care 2278E0002X 17 Therapist 172 Respiratory Therapist N Y
Individual or
Groups (of
Individuals)
Respiratory,
Developmental,
Rehabilitative and
Restorative
Service
Providers+&
Respiratory
Therapist,
Certified
Educational 2278E1000X 17 Therapist 172 Respiratory Therapist N Y
Individual or
Groups (of
Individuals)
Respiratory,
Developmental,
Rehabilitative and
Restorative
Service
Providers+&
Respiratory
Therapist,
Certified
Geriatric Care 2278G0305X 17 Therapist 172 Respiratory Therapist N Y
Individual or
Groups (of
Individuals)
Respiratory,
Developmental,
Rehabilitative and
Restorative
Service
Providers+&
Respiratory
Therapist,
Certified
General Care 2278G1100X 17 Therapist 172 Respiratory Therapist N Y
Individual or
Groups (of
Individuals)
Respiratory,
Developmental,
Rehabilitative and
Restorative
Service
Providers+&
Respiratory
Therapist,
Certified
Home Health 2278H0200X 17 Therapist 172 Respiratory Therapist N Y
Individual or
Groups (of
Individuals)
Respiratory,
Developmental,
Rehabilitative and
Restorative
Service
Providers+&
Respiratory
Therapist,
Certified
Pulmonary
Diagnostics 2278P1004X 17 Therapist 172 Respiratory Therapist N Y
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Individual or
Groups (of
Individuals)
Respiratory,
Developmental,
Rehabilitative and
Restorative
Service
Providers+&
Respiratory
Therapist,
Certified
Pulmonary
Rehabilitation 2278P1005X 17 Therapist 172 Respiratory Therapist N Y
Individual or
Groups (of
Individuals)
Respiratory,
Developmental,
Rehabilitative and
Restorative
Service
Providers+&
Respiratory
Therapist,
Certified
Pulmonary Function
Technologist 2278P1006X 17 Therapist 172 Respiratory Therapist N Y
Individual or
Groups (of
Individuals)
Respiratory,
Developmental,
Rehabilitative and
Restorative
Service
Providers+&
Respiratory
Therapist,
Certified
Palliative/Hospice 2278P3800X 17 Therapist 172 Respiratory Therapist N Y
Individual or
Groups (of
Individuals)
Respiratory,
Developmental,
Rehabilitative and
Restorative
Service
Providers+&
Respiratory
Therapist,
Certified
Neonatal/Pediatrics 2278P3900X 17 Therapist 172 Respiratory Therapist N Y
Individual or
Groups (of
Individuals)
Respiratory,
Developmental,
Rehabilitative and
Restorative
Service
Providers+&
Respiratory
Therapist,
Certified
Patient Transport 2278P4000X 17 Therapist 172 Respiratory Therapist N Y
Individual or
Groups (of
Individuals)
Respiratory,
Developmental,
Rehabilitative and
Restorative
Service
Providers+&
Respiratory
Therapist,
Certified
SNF/Subacute Care 2278S1500X 17 Therapist 172 Respiratory Therapist N Y
Individual or
Groups (of
Individuals)
Respiratory,
Developmental,
Rehabilitative and
Restorative
Service
Providers+&
Respiratory
Therapist,
Registered
Respiratory
Therapist, Registered 227900000X 17 Therapist 172 Respiratory Therapist N Y
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Individual or
Groups (of
Individuals)
Respiratory,
Developmental,
Rehabilitative and
Restorative
Service
Providers+&
Respiratory
Therapist,
Registered
Critical Care 2279C0205X 17 Therapist 172 Respiratory Therapist N Y
Individual or
Groups (of
Individuals)
Respiratory,
Developmental,
Rehabilitative and
Restorative
Service
Providers+&
Respiratory
Therapist,
Registered
Emergency Care 2279E0002X 17 Therapist 172 Respiratory Therapist N Y
Individual or
Groups (of
Individuals)
Respiratory,
Developmental,
Rehabilitative and
Restorative
Service
Providers+&
Respiratory
Therapist,
Registered
Educational 2279E1000X 17 Therapist 172 Respiratory Therapist N Y
Individual or
Groups (of
Individuals)
Respiratory,
Developmental,
Rehabilitative and
Restorative
Service
Providers+&
Respiratory
Therapist,
Registered
Geriatric Care 2279G0305X 17 Therapist 172 Respiratory Therapist N Y
Individual or
Groups (of
Individuals)
Respiratory,
Developmental,
Rehabilitative and
Restorative
Service
Providers+&
Respiratory
Therapist,
Registered
General Care 2279G1100X 17 Therapist 172 Respiratory Therapist N Y
Individual or
Groups (of
Individuals)
Respiratory,
Developmental,
Rehabilitative and
Restorative
Service
Providers+&
Respiratory
Therapist,
Registered
Home Health 2279H0200X 17 Therapist 172 Respiratory Therapist N Y
Individual or
Groups (of
Individuals)
Respiratory,
Developmental,
Rehabilitative and
Restorative
Service
Providers+&
Respiratory
Therapist,
Registered
Pulmonary
Diagnostics 2279P1004X 17 Therapist 172 Respiratory Therapist N Y
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Individual or
Groups (of
Individuals)
Respiratory,
Developmental,
Rehabilitative and
Restorative
Service
Providers+&
Respiratory
Therapist,
Registered
Pulmonary
Rehabilitation 2279P1005X 17 Therapist 172 Respiratory Therapist N Y
Individual or
Groups (of
Individuals)
Respiratory,
Developmental,
Rehabilitative and
Restorative
Service
Providers+&
Respiratory
Therapist,
Registered
Pulmonary Function
Technologist 2279P1006X 17 Therapist 172 Respiratory Therapist N Y
Individual or
Groups (of
Individuals)
Respiratory,
Developmental,
Rehabilitative and
Restorative
Service
Providers+&
Respiratory
Therapist,
Registered
Palliative/Hospice 2279P3800X 17 Therapist 172 Respiratory Therapist N Y
Individual or
Groups (of
Individuals)
Respiratory,
Developmental,
Rehabilitative and
Restorative
Service
Providers+&
Respiratory
Therapist,
Registered
Neonatal/Pediatrics 2279P3900X 17 Therapist 172 Respiratory Therapist N Y
Individual or
Groups (of
Individuals)
Respiratory,
Developmental,
Rehabilitative and
Restorative
Service
Providers+&
Respiratory
Therapist,
Registered
Patient Transport 2279P4000X 17 Therapist 172 Respiratory Therapist N Y
Individual or
Groups (of
Individuals)
Respiratory,
Developmental,
Rehabilitative and
Restorative
Service
Providers+&
Respiratory
Therapist,
Registered
SNF/Subacute Care 2279S1500X 17 Therapist 172 Respiratory Therapist N Y
Individual or
Groups (of
Individuals)
Respiratory,
Developmental,
Rehabilitative and
Restorative
Service Providers
Clinical Exercise
Physiologist
Clinical Exercise
Physiologist 224Y00000X 17
Clinical Exercise
Physiologist172 Respiratory Therapist N N
Individual or
Groups (of
Individuals)
Speech, Language
and Hearing
Service Providers
Speech-Language
Pathologist
Speech-Language
Pathologist 235Z00000X 17 Therapist 173
Speech/Hearing
TherapistY Y
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TennCare Taxonomy Crosswalk 7/17/2019
Individual or
Groups (of
Individuals)
Respiratory,
Developmental,
Rehabilitative and
Restorative
Service
Providers+&
Occupational
Therapy Assistant
Occupational
Therapy Assistant 224Z00000X 17 Therapist 174
Occupational Therapy
AssistantN Y
Individual or
Groups (of
Individuals)
Respiratory,
Developmental,
Rehabilitative and
Restorative
Service Providers
Occupational
Therapy Assistant
Environmental
Modification
Specialization
224ZE0001X 17 Assistant Therapist 174Occupational Therapy
AssistantN Y
Individual or
Groups (of
Individuals)
Respiratory,
Developmental,
Rehabilitative and
Restorative
Service Providers
Occupational
Therapy Assistant
Feeding, Eating &
Swallowing
Specialization
224ZF0002X 17 Assistant Therapist 174Occupational Therapy
AssistantN Y
Individual or
Groups (of
Individuals)
Respiratory,
Developmental,
Rehabilitative and
Restorative
Service Providers
Occupational
Therapy Assistant
Low Vision
Specialization224ZL0004X 17 Assistant Therapist 174
Occupational Therapy
AssistantN Y
Individual or
Groups (of
Individuals)
Respiratory,
Developmental,
Rehabilitative and
Restorative
Service Providers
Occupational
Therapy Assistant
Driving &
Community Mobility
Specialization
224ZR0403X 17 Assistant Therapist 174Occupational Therapy
AssistantN Y
Individual or
Groups (of
Individuals)
Respiratory,
Developmental,
Rehabilitative and
Restorative
Service
Providers+&
Physical Therapy
Assistant
Physical Therapy
Assistant 225200000X 17 Therapist 175
Physical Therapy
AssistantN Y
Individual or
Groups (of
Individuals)
Eye and Vision
Services
Providers
Optometrist Optometrist 152W00000X 18 Optometrist 180 Optometrist Y Y
Individual or
Groups (of
Individuals)
Eye and Vision
Services
Providers
Optometrist Corneal and Contact
Management 152WC0802X 18 Optometrist 180 Optometrist Y Y
Individual or
Groups (of
Individuals)
Eye and Vision
Services
Providers
Optometrist Low Vision
Rehabilitation 152WL0500X 18 Optometrist 180 Optometrist Y Y
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Individual or
Groups (of
Individuals)
Eye and Vision
Services
Providers
Optometrist Pediatrics 152WP0200X 18 Optometrist 180 Optometrist Y Y
Individual or
Groups (of
Individuals)
Eye and Vision
Services
Providers
Optometrist Sports Vision 152WS0006X 18 Optometrist 180 Optometrist Y Y
Individual or
Groups (of
Individuals)
Eye and Vision
Services
Providers
Optometrist Vision Therapy 152WV0400X 18 Optometrist 180 Optometrist Y Y
Individual or
Groups (of
Individuals)
Eye and Vision
Services
Providers
Optometrist Occupational Vision 152WX0102X 18 Optometrist 180 Optometrist Y Y
Individual or
Groups (of
Individuals)
Eye and Vision
Services
Providers
Technician/Techn
ologist
Technician/Technolo
gist 156F00000X 19 Optician 190 Optician Y Y
Individual or
Groups (of
Individuals)
Eye and Vision
Services
Providers
Technician/Techn
ologist Contact Lens 156FC0800X 19 Optician 190 Optician Y Y
Individual or
Groups (of
Individuals)
Eye and Vision
Services
Providers
Technician/Techn
ologist Contact Lens Fitter 156FC0801X 19 Optician 190 Optician Y Y
Individual or
Groups (of
Individuals)
Eye and Vision
Services
Providers
Technician/Techn
ologist Ophthalmic 156FX1100X 19 Optician 190 Optician Y Y
Individual or
Groups (of
Individuals)
Eye and Vision
Services
Providers
Technician/Techn
ologist
Ophthalmic
Assistant 156FX1101X 19 Optician 190 Optician Y Y
Individual or
Groups (of
Individuals)
Eye and Vision
Services
Providers
Technician/Techn
ologist Optometric Assistant 156FX1201X 19 Optician 190 Optician Y Y
Individual or
Groups (of
Individuals)
Eye and Vision
Services
Providers
Technician/Techn
ologist
Optometric
Technician 156FX1202X 19 Optician 190 Optician Y Y
Individual or
Groups (of
Individuals)
Eye and Vision
Services
Providers
Technician/Techn
ologist Ocularist 156FX1700X 19 Optician 190 Optician Y Y
Individual or
Groups (of
Individuals)
Eye and Vision
Services
Providers
Technician/Techn
ologist Optician 156FX1800X 19 Optician 190 Optician Y Y
Individual or
Groups (of
Individuals)
Eye and Vision
Services
Providers
Technician/Techn
ologist Orthoptist 156FX1900X 19 Optician 190 Optician Y Y
Individual or
Groups (of
Individuals)
Speech, Language
and Hearing
Service Providers
Audiologist Audiologist 231H00000X 20 Audiologist 200 Audiologist Y Y
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Individual or
Groups (of
Individuals)
Speech, Language
and Hearing
Service Providers
Audiologist
Assistive
Technology
Practitioner
231HA2400X 20 Audiologist 251 Assistive Technology N N
Individual or
Groups (of
Individuals)
Speech, Language
and Hearing
Service Providers
Audiologist Assistive
Technology Supplier 231HA2500X 20 Audiologist 621
Assistive Technology
SupplierN N
Individual or
Groups (of
Individuals)
Speech, Language
and Hearing
Service Providers
Audiologist-
Hearing Aid Fitter
Audiologist-Hearing
Aid Fitter 237600000X 20 Audiologist 625
Audiologist-Hearing
Aid Fitter N N
Non-individual Agencies Case Management Case Management 251B00000X 21Case Manager
(Targeted)210
Care Coordinator for
Pregnant WomenN N
Non-individual Agencies Case Management Case Management 251B00000X 21Case Manager
(Targeted)211 HIV Case Manager N N
Individual or
Groups (of
Individuals)
Other Service
Providers
Case
Manager/Care
Coordinator
Case Manager/Care
Coordinator 171M00000X 21
Case Manager
(Targeted)213 E.I. Case Management N N
Non-individual Agencies Case Management Case Management 251B00000X 21Case Manager
(Targeted)213 E.I. Case Manager N N
Non-individual Agencies Case Management Case Management 251B00000X 21Case Manager
(Targeted)214
High Risk Pregnant
WomenN N
Non-individual Agencies Case Management Case Management 251B00000X 21Case Manager
(Targeted)215 TB Case Management N N
Non-individual Agencies Case Management Case Management 251B00000X 21Case Manager
(Targeted)216
OJA Targeted Case
ManagementN N
Non-individual Agencies Case Management Case Management 251B00000X 21Case Manager
(Targeted)217
Child Welfare Targeted
Case ManagementN N
Non-individual Agencies Case Management Case Management 251B00000X 21Case Manager
(Targeted)218 DDSD/ICFMR Waiver N N
Non-individual Agencies Case Management Case Management 251B00000X 21Case Manager
(Targeted)219
TCM 1st Time
Mothers/InfantsN N
Non-individual Agencies Case Management Case Management 251B00000X 21Case Manager
(Targeted)221
MH Case Mgmt All
AgesN N
Non-individual Agencies Case Management Case Management 251B00000X 21Case Manager
(Targeted)222
MH Case Mgmt, Over
21, PublicN N
Non-individual Agencies Case Management Case Management 251B00000X 21Case Manager
(Targeted)223
MH Case Mgmt, Over
21, ContractedN N
Non-individual Agencies Case Management Case Management 251B00000X 21Case Manager
(Targeted)224
MH Case Mgmt, Over
21, PrivateN N
Non-individual Agencies Case Management Case Management 251B00000X 21Case Manager
(Targeted)225
MH Case Mgmt, Under
21, PublicN N
Non-individual Agencies Case Management Case Management 251B00000X 21Case Manager
(Targeted)226
MH Case Mgmt, Under
21, ContractedN N
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Non-individual Agencies Case Management Case Management 251B00000X 21Case Manager
(Targeted)227
MH Case Mgmt, Under
21, PrivateN N
Non-individual Agencies Case Management Case Management 251B00000X 21Case Manager
(Targeted)228
Advantage Case
ManagerN N
Non-individual Agencies Supports
Brokerage Supports Brokerage 251X00000X 21
Case Manager
(Targeted)228
Advantage Case
ManagerN N
Non-individual Suppliers Hearing Aid
Equipment
Hearing Aid
Equipment 332S00000X 22 Hearing Aid Dealer 220 Hearing Aid Dealer N Y
Individual or
Groups (of
Individuals)
Dietary &
Nutritional
Service Providers
Nutritionist Nutritionist 133N00000X 23 Nutritionist 210Care Coordinator for
Pregnant WomenN Y
Individual or
Groups (of
Individuals)
Dietary &
Nutritional
Service Providers
Nutritionist Nutritionist 133N00000X 23 Nutritionist 211 HIV Case Manager N Y
Individual or
Groups (of
Individuals)
Dietary &
Nutritional
Service Providers
Dietary Manager Dietary Manager 132700000X 23 Nutritionist 230 Nutritionist N Y
Individual or
Groups (of
Individuals)
Dietary &
Nutritional
Service Providers
Nutritionist Nutritionist 133N00000X 23 Nutritionist 230 Nutritionist N Y
Individual or
Groups (of
Individuals)
Dietary &
Nutritional
Service Providers
Nutritionist Nutrition, Education 133NN1002X 23 Nutritionist 230 Nutritionist N Y
Individual or
Groups (of
Individuals)
Dietary &
Nutritional
Service Providers
Dietitian,
Registered Dietitian, Registered 133V00000X 23 Nutritionist 230 Nutritionist N Y
Individual or
Groups (of
Individuals)
Dietary &
Nutritional
Service Providers
Dietitian,
Registered Nutrition, Pediatric 133VN1004X 23 Nutritionist 230 Nutritionist N Y
Individual or
Groups (of
Individuals)
Dietary &
Nutritional
Service Providers
Dietitian,
Registered Nutrition, Renal 133VN1005X 23 Nutritionist 230 Nutritionist N Y
Individual or
Groups (of
Individuals)
Dietary &
Nutritional
Service Providers
Dietitian,
Registered Nutrition, Metabolic 133VN1006X 23 Nutritionist 230 Nutritionist N Y
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Individual or
Groups (of
Individuals)
Dietary &
Nutritional
Service Providers
Dietetic
Technician,
Registered
Dietetic Technician,
Registered 136A00000X 23 Nutritionist 230 Nutritionist N Y
Individual or
Groups (of
Individuals)
Dietary &
Nutritional
Service Providers
Dietetic
Technician,
Registered
Dietetic Technician,
Registered 133VN1101X 23
Gerontological
Nutrition677
Gerontological
NutritionN Y
Individual or
Groups (of
Individuals)
Dietary &
Nutritional
Service Providers
Dietetic
Technician,
Registered
Dietetic Technician,
Registered 133VN1201X 23
Obesity and Weight
Management 678
Obesity and Weight
Management N Y
Individual or
Groups (of
Individuals)
Dietary &
Nutritional
Service Providers
Dietetic
Technician,
Registered
Dietetic Technician,
Registered 133VN1301X 23 Oncology Nutrition 679 Oncology Nutrition N Y
Individual or
Groups (of
Individuals)
Dietary &
Nutritional
Service Providers
Dietetic
Technician,
Registered
Dietetic Technician,
Registered 133VN1401X 23
Pediatric Critial Care
Nutrition680
Pediatric Critial Care
NutritionN Y
Individual or
Groups (of
Individuals)
Dietary &
Nutritional
Service Providers
Dietetic
Technician,
Registered
Dietetic Technician,
Registered 133VN1501X 23
Sports Dietetics
Nutrition681
Sports Dietetics
NutritionN Y
Non-individual Suppliers
Military/U.S.
Coast Guard
Pharmacy
Military/U.S. Coast
Guard Pharmacy 332000000X 24 Pharmacy 240 Pharmacy Y Y
Non-individual Suppliers
Department of
Veterans Affairs
(VA) Pharmacy
Department of
Veterans Affairs
(VA) Pharmacy
332100000X 24 Pharmacy 240 Pharamacy Y Y
Non-individual Suppliers
Indian Health
Service/Tribal/Ur
ban Indian Health
(I/T/U) Pharmacy
Indian Health
Service/Tribal/Urban
Indian Health
(I/T/U) Pharmacy
332800000X 24 Pharmacy 240 Pharmacy Y Y
Non-individual Suppliers Pharmacy Pharmacy 333600000X 24 Pharmacy 240 Pharmacy Y Y
Non-individual Suppliers Pharmacy Clinic Pharmacy 3336C0002X 24 Pharmacy 240 Pharmacy Y Y
Non-individual Suppliers Pharmacy Community/Retail
Pharmacy 3336C0003X 24 Pharmacy 240 Pharmacy Y Y
Non-individual Suppliers Pharmacy Compounding
Pharmacy 3336C0004X 24 Pharmacy 240 Pharmacy Y Y
Non-individual Suppliers Pharmacy Home Infusion
Therapy Pharmacy 3336H0001X 24 Pharmacy 240 Pharmacy Y Y
Non-individual Suppliers Pharmacy Institutional
Pharmacy 3336I0012X 24 Pharmacy 240 Pharmacy Y Y
Non-individual Suppliers Pharmacy Long Term Care
Pharmacy 3336L0003X 24 Pharmacy 240 Pharmacy Y Y
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Non-individual Suppliers Pharmacy Mail Order
Pharmacy 3336M0002X 24 Pharmacy 240 Pharmacy Y Y
Non-individual Suppliers Pharmacy
Managed Care
Organization
Pharmacy
3336M0003X 24 Pharmacy 240 Pharmacy Y Y
Non-individual Suppliers Pharmacy Nuclear Pharmacy 3336N0007X 24 Pharmacy 240 Pharmacy Y Y
Non-individual Suppliers Pharmacy Specialty Pharmacy 3336S0011X 24 Pharmacy 240 Pharmacy Y Y
Non-individual Suppliers Pharmacy Pharmacy 333600000X 24 Pharmacy 250DME/Medical Supply
DealerN Y
Non-individual Suppliers
Durable Medical
Equipment &
Medical Supplies
Durable Medical
Equipment &
Medical Supplies
332B00000X 25DME/Medical Supply
Dealer250
DME/Medical Supply
DealerY Y
Non-individual Suppliers
Durable Medical
Equipment &
Medical Supplies
Customized
Equipment 332BC3200X 25
DME/Medical Supply
Dealer250
DME/Medical Supply
DealerY Y
Non-individual Suppliers
Durable Medical
Equipment &
Medical Supplies
Dialysis Equipment
& Supplies 332BD1200X 25
DME/Medical Supply
Dealer250
DME/Medical Supply
DealerY Y
Non-individual Suppliers
Durable Medical
Equipment &
Medical Supplies
Nursing Facility
Supplies 332BN1400X 25
DME/Medical Supply
Dealer250
DME/Medical Supply
DealerY Y
Non-individual Suppliers
Durable Medical
Equipment &
Medical Supplies
Parenteral & Enteral
Nutrition 332BP3500X 25
DME/Medical Supply
Dealer250
DME/Medical Supply
DealerY Y
Non-individual Suppliers
Durable Medical
Equipment &
Medical Supplies
Oxygen Equipment
& Supplies 332BX2000X 25
DME/Medical Supply
Dealer250
DME/Medical Supply
DealerY Y
Non-individual Suppliers
Eyewear Supplier
(Equipment, not
the service)
Eyewear Supplier
(Equipment, not the
service)
332H00000X 25DME/Medical Supply
Dealer250
DME/Medical Supply
DealerY Y
Non-individual Suppliers Medical Foods
Supplier
Medical Foods
Supplier 335G00000X 25
Medical Foods
Supplier/DME250 DME/Medical Supplier Y Y
Non-individual Suppliers Portable X-Ray
Supplier
Portable X-Ray
Supplier 335V00000X 25
DME/Medical Supply
Dealer250
DME/Medical Supply
DealerY Y
Non-individual Suppliers
Durable Medical
Equipment &
Medical Supplies
Durable Medical
Equipment &
Medical Supplies
332B00000X 25DME/Medical Supply
Dealer251 Assistive Technology N Y
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Non-individual Suppliers Prosthetic/Orthoti
c Supplier
Prosthetic/Orthotic
Supplier 335E00000X 25
DME/Medical Supply
Dealer277 Prosthesis Y Y
Non-individual Transportation
ServicesAmbulance Ambulance 341600000X 26 Transportation Provider 260 Ambulance Y N
Non-individual Transportation
ServicesAmbulance Land Transport 3416L0300X 26 Transportation Provider 260 Ambulance Y N
Non-individual Transportation
ServicesAmbulance Water Transport 3416S0300X 26 Transportation Provider 260 Ambulance Y N
Non-individual Transportation
Services
Military/U.S.
Coast Guard
Transport
Military/U.S. Coast
Guard Transport 341800000X 26 Transportation Provider 260 Ambulance Y N
Non-individual Transportation
Services
Military/U.S.
Coast Guard
Transport
Military or U.S.
Coast Guard
Ambulance, Ground
Transport
3418M1110X 26 Transportation Provider 260 Ambulance Y N
Non-individual Transportation
Services
Military/U.S.
Coast Guard
Transport
Military or U.S.
Coast Guard
Ambulance, Water
Transport
3418M1130X 26 Transportation Provider 260 Ambulance Y N
Non-individual Transportation
ServicesAmbulance Air Transport 3416A0800X 26 Transportation Provider 261 Air Ambulance Y N
Non-individual Transportation
Services
Military/U.S.
Coast Guard
Transport
Military or U.S.
Coast Guard
Ambulance, Air
Transport
3418M1120X 26 Transportation Provider 261 Air Ambulance Y N
Non-individual Transportation
ServicesBus Bus 347B00000X 26 Transportation Provider 262 Bus Y N
Non-individual Transportation
ServicesTaxi Taxi 344600000X 26 Transportation Provider 263 Taxi Y N
Individual or
Groups (of
Individuals)
Other Service
ProvidersDriver Driver 172A00000X 26 Transportation Provider 264
Common Carrier
(Ambulatory)Y N
Non-individual Transportation
Services
Non-emergency
Medical Transport
(VAN)
Non-emergency
Medical Transport
(VAN)
343900000X 26 Transportation Provider 264Common Carrier
(Ambulatory)Y N
Individual or
Groups (of
Individuals)
Other Service
ProvidersFuneral Director Funeral Director 176P00000X 26 Transportation Provider 265
Common Carrier (Non-
ambulatory)N N
Non-individual Transportation
Services
Non-emergency
Medical Transport
(VAN)
Non-emergency
Medical Transport
(VAN)
343900000X 26 Transportation Provider 265Common Carrier (Non-
Ambulatory)Y N
Non-individual Transportation
ServicesTrain Train 347D00000X 26 Transportation Provider 265
Common Carrier (Non-
Ambulatory)Y N
Non-individual Transportation
Services
Transportation
Broker
Transportation
Broker 347E00000X 26 Transportation Provider 265
Common Carrier (Non-
Ambulatory)Y N
Page 41 of 80
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Non-individual Transportation
ServicesAir Carrier Air Carrier 344800000X 26 Transportation Provider 265
Common Carrier (Non-
Ambulatory)y N
Non-individual Transportation
ServicesPrivate Vehicle Private Vehicle 347C00000X 26 Transportation Provider 266 Family Member Y N
Non-individual Transportation
Services
Non-emergency
Medical Transport
(VAN)
Non-emergency
Medical Transport
(VAN)
343900000X 26 Transportation Provider 267 Volunteer Y N
Non-individual Transportation
Services
Secured Medical
Transport (VAN)
Secured Medical
Transport (VAN) 343800000X 26 Transportation Provider 268
Secured Medical
Transport (VAN)y N
Individual or
Groups (of
Individuals)
Dental Providers Dentist Endodontics 1223E0200X 27 Dentist 270 Endodontist Y Y
Individual or
Groups (of
Individuals)
Dental Providers Dentist Dentist 122300000X 27 Dentist 271General Dentistry
PractitionerY Y
Individual or
Groups (of
Individuals)
Dental Providers Dentist Dental Public Health 1223D0001X 27 Dentist 271General Dentistry
PractitionerY Y
Individual or
Groups (of
Individuals)
Dental Providers Dentist General Practice 1223G0001X 27 Dentist 271General Dentistry
PractitionerY Y
Individual or
Groups (of
Individuals)
Dental Providers Denturist Denturist 122400000X 27 Dentist 271General Dentistry
PractitionerY Y
Individual or
Groups (of
Individuals)
Dental Providers Dentist
Oral and
Maxillofacial
Surgery
1223S0112X 27 Dentist 272 Oral Surgeon Y Y
Individual or
Groups (of
Individuals)
Dental Providers Dentist
Orthodontics and
Dentofacial
Orthopedics
1223X0400X 27 Dentist 273 Orthodontist Y Y
Individual or
Groups (of
Individuals)
Dental Providers Dentist Pediatric Dentistry 1223P0221X 27 Dentist 274 Pediatric Dentist Y Y
Individual or
Groups (of
Individuals)
Dental Providers Dentist Periodontics 1223P0300X 27 Dentist 275 Periodontist Y Y
Individual or
Groups (of
Individuals)
Dental Providers Dentist
Oral and
Maxillofacial
Pathology
1223P0106X 27 Dentist 276 Oral Pathologist N Y
Individual or
Groups (of
Individuals)
Dental Providers Dentist Prosthodontics 1223P0700X 27 Dentist 278 Prosthodontist Y Y
Individual or
Groups (of
Individuals)
Dental Providers Dentist
Oral and
Maxillofacial
Radiology
1223X0008X 27 Dentist 341 Radiologist N N
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Individual or
Groups (of
Individuals)
Dental Providers Dentist Dentist
Anesthesiologist1223D0004X 27 Dentist 669
Anesthesiologist -
OtherN Y
Individual or
Groups (of
Individuals)
Dental Providers Dentist Orafacial Pain 1223X2210X 27 Dentist 676 Orafacial Pain Y Y
Individual or
Groups (of
Individuals)
Dental Providers Dentist Oral Medicinist 125Q00000X 27 Oral Medicinise 683 Oral Medicinist Y Y
Individual or
Groups (of
Individuals)
Dental Providers Dentist Dentist Therapist 125J00000X 27 Dental Therapist 999 Miscellaneous N N
Individual or
Groups (of
Individuals)
Dental Providers Dentist Advanced Practice
Dental Therapist125K00000X 27
Advanced Dental
Therapist999 Miscellaneous N N
Individual or
Groups (of
Individuals)
Dental Providers Dentist Oral Medicinist 125Q00000X 27 Oral Medicine 999 Miscellaneous N N
Non-individual Laboratories
Military Clinical
Medical
Laboratory
Military Clinical
Medical Laboratory 291900000X 28 Laboratory 280 Independent Lab Y Y
Non-individual LaboratoriesClinical Medical
Laboratory
Clinical Medical
Laboratory 291U00000X 28 Laboratory 280 Independent Lab Y Y
Non-individual Laboratories Dental Laboratory Dental Laboratory 292200000X 28 Laboratory 280 Independent Lab Y Y
Non-individual LaboratoriesPhysiological
Laboratory
Physiological
Laboratory 293D00000X 28 Laboratory 280 Independent Lab Y Y
Non-individual
Ambulatory
Health Care
Facilities
Clinic/Center Radiology, Mobile 261QR0208X 28 Laboratory 281 Mobile Lab N Y
Non-individual
Ambulatory
Health Care
Facilities
Clinic/Center Radiology 261QR0200X 29 X-Ray Clinic 290Freestanding X-Ray
ClinicY Y
Non-individual
Ambulatory
Health Care
Facilities
Clinic/Center Radiology, Mobile
Mammography 261QR0207X 29 X-Ray Clinic 291 Mobile X-Ray Clinic Y Y
Non-individual
Ambulatory
Health Care
Facilities
Clinic/Center Radiology, Mobile 261QR0208X 29 X-Ray Clinic 291 Mobile X-Ray Clinic Y Y
Non-individual
Ambulatory
Health Care
Facilities
Clinic/Center Radiology,
Mammography 261QR0206X 29 X-Ray Clinic 292 Mammography N Y
Non-individual
Ambulatory
Health Care
Facilities
Clinic/Center
End-Stage Renal
Disease (ESRD)
Treatment
261QE0700X 30End-Stage Renal
Disease (RSD) Clinic300
Free-standing Renal
Dialysis ClinicY Y
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Individual or
Groups (of
Individuals)
Chiropractic
ProvidersChiropractor Chiropractor 111N00000X 31 Physician 150 Chiropractor Y Y
Individual or
Groups (of
Individuals)
Eye and Vision
Services
Providers
Technician/Techn
ologist Optician 156FX1800X 31 Physician 190 Optician Y Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Pediatrics
Child Abuse
Pediatrics
Specialization
2080C0008X 31Case Manager
(Targeted)217
Child Welfare Targeted
Case ManagementY Y
Individual or
Groups (of
Individuals)
Dental Providers Dentist
Oral and
Maxillofacial
Surgery
1223S0112X 31 Physician 272 Oral Surgeon Y Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Allergy &
Immunology
Allergy &
Immunology207K00000X 31 Physician 310 Allergist Y Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Allergy &
ImmunologyAllergy 207KA0200X 31 Physician 310 Allergist Y Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Allergy &
Immunology
Clinical &
Laboratory
Immunology
207KI0005X 31 Physician 310 Allergist Y Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Internal MedicineAllergy &
Immunology 207RA0201X 31 Physician 310 Allergist Y Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Anesthesiology Anesthesiology 207L00000X 31 Physician 311 Anesthesiologist Y Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
AnesthesiologyCritical Care
Medicine207LC0200X 31 Physician 311 Anesthesiologist Y Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Anesthesiology
Hospice and
Palliative
Medicine**
207LH0002X 31 Physician 311 Anesthesiologist Y Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Anesthesiology Pain Medicine 207LP2900X 31 Physician 311 Anesthesiologist Y Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
AnesthesiologyPediatric
Anesthesiology207LP3000X 31 Physician 311 Anesthesiologist Y Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Internal Medicine
Advanced Heart
Failure and
Transplant
Caridology
207RA0001X 31 Physician 312 Cardiologist Y Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Internal MedicineCardiovascular
Disease 207RC0000X 31 Physician 312 Cardiologist Y Y
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TennCare Taxonomy Crosswalk 7/17/2019
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Internal MedicineInterventional
Cardiology207RI0011X 31 Physician 312 Cardiologist Y Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Pediatrics Pediatric Cardiology 2080P0202X 31 Physician 312 Cardiologist Y Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Internal Medicine
Advanced Heart
Failure and
Transplant
Caridology
207RA00001X 31 Physician 312 Cardiologist Y Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Surgery Vascular Surgery 2086S0129X 31 Physician 313 Cardiovascular Surgeon Y Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Dermatology Dermatology 207N00000X 31 Physician 314 Dermatologist Y Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Dermatology
MOHS-
Micrographic
Surgery##
207ND0101X 31 Physician 314 Dermatologist Y Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Dermatology Family Medicine+ 207ND0900X 31 Physician 314 Dermatologist Y Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Dermatology
Clinical &
Laboratory
Dermatological
Immunology
207NI0002X 31 Physician 314 Dermatologist Y Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Dermatology Pediatric
Dermatology 207NP0225X 31 Physician 314 Dermatologist Y Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Dermatology
Procedural
Dermatology (title
change from
Dermatological
Surgery effective
20080401)##
207NS0135X 31 Physician 314 Dermatologist Y Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Emergency
Medicine
Emergency
Medicine 207P00000X 31 Physician 315
Emergency Medicine
PractitionerY Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Emergency
Medicine
Emergency Medical
Services 207PE0004X 31 Physician 315
Emergency Medicine
PractitionerY Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Emergency
Medicine
Undersea and
Hyperbaric
Medicine
207PE0005X 31 Physician 315Emergency Medicine
PractitionerY Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Emergency
Medicine
Hospice and
Palliative
Medicine**
207PH0002X 31 Physician 315Emergency Medicine
PractitionerY Y
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TennCare Taxonomy Crosswalk 7/17/2019
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Emergency
Medicine
Pediatric Emergency
Medicine 207PP0204X 31 Physician 315
Emergency Medicine
PractitionerY Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Emergency
Medicine Sports Medicine 207PS0010X 31 Physician 315
Emergency Medicine
PractitionerY Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Emergency
Medicine Medical Toxicology 207PT0002X 31 Physician 315
Emergency Medicine
PractitionerY Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Pediatrics Pediatric Emergency
Medicine 2080P0204X 31 Physician 315
Emergency Medicine
PractitionerY Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Family
Medicine+ Family Medicine+ 207Q00000X 31 Physician 316 Family Practitioner Y Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Family
Medicine+ Adolescent Medicine 207QA0000X 31 Physician 316 Family Practitioner Y Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Family
Medicine+ Adult Medicine 207QA0505X 31 Physician 316 Family Practitioner Y Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Family
Medicine+
Bariatric
Medicine**** 207QB0002X 31 Physician 316 Family Practitioner Y N
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Family
Medicine+
Hospice and
Palliative
Medicine**
207QH0002X 31 Physician 316 Family Practitioner Y Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Family
Medicine+ Sports Medicine 207QS0010X 31 Physician 316 Family Practitioner Y Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Family MedicineSleep Medicine
Specialization207QS1201X 31 Physician 316 Family Practitioner Y Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Internal Medicine Gastroenterology 207RG0100X 31 Physician 317 Gastroenterologist Y Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Internal Medicine Hepatology 207RI0008X 31 Physician 317 Gastroenterologist Y Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Pediatrics Pediatric
Gastroenterology 2080P0206X 31 Physician 317 Gastroenterologist Y Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Preventive
Medicine -Aerospace Medicine 2083A0100X 31 Physician 318 General Practitioner Y Y
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Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Preventive
Medicine -Clinical Informatics 2083C0008X 31 Physician 318 Clinical informatics N Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Preventive
Medicine -
Undersea and
Hyperbaric Medicine 2083P0011X 31 Physician 318 General Practitioner Y Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Preventive
Medicine -
Preventive
Medicine/Occupatio
nal Environmental
Medicine
2083P0500X 31 Physician 318 General Practitioner Y Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Preventive
Medicine -
Public Health &
General Preventive
Medicine
2083P0901X 31 Physician 318 General Practitioner Y Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Preventive
Medicine -Sports Medicine 2083S0010X 31 Physician 318 General Practitioner Y Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Preventive
Medicine -Medical Toxicology 2083T0002X 31 Physician 318 General Practitioner Y Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Preventive
Medicine -
Occupational
Medicine 2083X0100X 31 Physician 318 General Practitioner Y Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
General Practice General Practice 208D00000X 31 Physician 318 General Practitioner Y Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Hospitalist Hospitalist 208M00000X 31 Physician 318 General Practitioner Y Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Oral &
Maxillofacial
Surgery
Oral & Maxillofacial
Surgery204E00000X 31 Physician 319 General Surgeon Y Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Transplant
Surgery Transplant Surgery 204F00000X 31 Physician 319 General Surgeon Y Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Surgery Surgery 208600000X 31 Physician 319 General Surgeon Y Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Surgery
Hospice and
Palliative
Medicine**
2086H0002X 31 Physician 319 General Surgeon Y Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Surgery Surgical Critical
Care 2086S0102X 31 Physician 319 General Surgeon Y Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Surgery Trauma Surgery## 2086S0127X 31 Physician 319 General Surgeon Y Y
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TennCare Taxonomy Crosswalk 7/17/2019
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Family
Medicine+ Geriatric Medicine 207QG0300X 31 Physician 320 Geriatric Practitioner N Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Orthopaedic
SurgeryHand Surgery 207XS0106X 31 Physician 321 Hand Surgeon Y Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Plastic Surgery Surgery of the Hand 2082S0105X 31 Physician 321 Hand Surgeon Y Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Surgery Surgery of the Hand 2086S0105X 31 Physician 321 Hand Surgeon Y Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Internal Medicine Internal Medicine 207R00000X 31 Physician 322 Internist Y Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Internal MedicineAdolescent
Medicine 207RA0000X 31 Physician 322 Internist Y Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Internal MedicineBariatric
Medicine**** 207RB0002X 31 Physician 322 Internist Y Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Internal MedicineClinical Cardiac
Electrophysiology207RC0001X 31 Physician 322 Internist Y Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Internal MedicineCritical Care
Medicine207RC0200X 31 Physician 322 Internist Y Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Internal Medicine Geriatric Medicine 207RG0300X 31 Physician 322 Internist Y Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Internal Medicine
Hospice and
Palliative
Medicine**
207RH0002X 31 Physician 322 Internist Y Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Internal Medicine
Clinical &
Laboratory
Immunology
207RI0001X 31 Physician 322 Internist Y Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Internal MedicineMagnetic Resonance
Imaging (MRI)207RM1200X 31 Physician 322 Internist Y Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Internal Medicine Sports Medicine 207RS0010X 31 Physician 322 Internist Y Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Internal Medicine Sleep Medicine 207RS0012X 31 Physician 322 Internist Y Y
Page 48 of 80
TennCare Taxonomy Crosswalk 7/17/2019
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Internal MedicineTransplant
Hepatology****207RT0003X 31 Physician 322 Internist Y N
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Internal Medicine Hypertension
Specialist 207RH0005X 31
Hpertension Specialist
Physician322 Internist Y Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Pediatrics Neonatal-Perinatal
Medicine2080N0001X 31 Physician 323 Neonatologist N Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Internal Medicine Nephrology 207RN0300X 31 Physician 324 Nephrologist Y Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Pediatrics Pediatric Nephrology 2080P0210X 31 Physician 324 Nephrologist Y Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Neurological
Surgery
Neurological
Surgery207T00000X 31 Physician 325 Neurological Surgeon Y Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Psychiatry &
Neurology -
Neuromuscular
Medicine**** 2084N0008X 31 Physician 326 Neurologist Y N
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Psychiatry &
Neurology -Neurology# 2084N0400X 31 Physician 326 Neurologist Y Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Psychiatry &
Neurology -
Neurology with
Special
Qualifications in
Child Neurology#
2084N0402X 31 Physician 326 Neurologist Y Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Psychiatry &
Neurology -
Clinical
Neurophysiology# 2084N0600X 31 Physician 326 Neurologist Y Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Psychiatry &
Neurology -
Neurodevelopmental
Disabilities 2084P0005X 31 Physician 326 Neurologist Y Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Psychiatry &
Neurology -
Psychosomatic
Medicine** 2084P0015X 31 Physician 326 Neurologist Y Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Psychiatry &
Neurology -Pain Medicine 2084P2900X 31 Physician 326 Neurologist Y Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Psychiatry &
Neurology -Sports Medicine 2084S0010X 31 Physician 326 Neurologist Y Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Psychiatry &
Neurology -Sleep Medicine 2084S0012X 31 Physician 326 Neurologist Y Y
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TennCare Taxonomy Crosswalk 7/17/2019
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Psychiatry &
Neurology -Vascular Neurology# 2084V0102X 31 Physician 326 Neurologist Y Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Psychiatry &
Neurology
Behavioral
Neurology &
Neuropsychiatry
Speciality
2084B0040X 31 Physician 326 Neurologist Y Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Psychiatry &
Neurology Neurocritcal Care 2084A2900X 31 Other 326 Neurocritcal Care N Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Neuromusculoskel
etal Medicine,
Sports Medicine
Neuromusculoskelet
al Medicine, Sports
Medicine
204C00000X 31 Physician 327Nuclear Medicine
PractitionerY Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Nuclear Medicine Nuclear Medicine 207U00000X 31 Physician 327Nuclear Medicine
PractitionerY Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Nuclear Medicine Nuclear Cardiology 207UN0901X 31 Physician 327Nuclear Medicine
PractitionerY Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Nuclear MedicineNuclear Imaging &
Therapy207UN0902X 31 Physician 327
Nuclear Medicine
PractitionerY Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Nuclear MedicineIn Vivo & In Vitro
Nuclear Medicine207UN0903X 31 Physician 327
Nuclear Medicine
PractitionerY Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Obstetrics &
Gynecology
Obstetrics &
Gynecology207V00000X 31 Physician 328
Obstetrician/Gynecolog
istY Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Obstetrics &
Gynecology
Bariatric
Medicine****207VB0002X 31 Physician 328 Obstretrician/Gyn Y N
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Obstetrics &
Gynecology
Critical Care
Medicine207VC0200X 31 Physician 328
Obstetrician/Gynecolog
istY Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Obstetrics &
Gynecology
Reproductive
Endocrinology207VE0102X 31 Physician 328
Obstetrician/Gynecolog
istY Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Obstetrics &
Gynecology
Hospice and
Palliative
Medicine**
207VH0002X 31 Physician 328Obstetrician/Gynecolog
istY Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Obstetrics &
Gynecology
Female Pelvic
Medicine and
Reconstructive
Surgery
207VF0040X 31 Physician 328Obstetrician/Gynecolog
istY Y
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Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Internal MedicineHematology &
Oncology207RH0003X 31 Physician 329
Oncologist (including
Hematology)N Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Ophthalmology Ophthalmology 207W00000X 31 Physician 330 Glaucoma Specialist Y Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Ophthalmology Ophthalmology 207WX0107X 31 Physician 330 Retina Specialist Y Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Ophthalmology Ophthalmology 207WX0108X 31 Physician 330Uveitis and Ocular
Inflammatory DiseaseY Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Ophthalmology Ophthalmology 207WX0109X 31 Physician 330 Neuro Opthamologist Y Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Ophthalmology Ophthalmology 207WX0110X 31 Physician 330
Opthamologist
Pediatric Strabismus
Specialist
Y Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Ophthalmology
Ophthalmic Plastic
and Reconstructive
Surgery
207WX0200X 31 Physician 330 Opthamologist Y Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Ophthalmology Ophthalmology 207WX0009X 31 Physician 330 Opthamologist Y Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Orthopaedic
SurgeryOrthopaedic Surgery 207X00000X 31 Physician 331 Orthopedic Surgeon Y Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Orthopaedic
Surgery
Pediatric
Orthopaedic Surgery207XP3100X 31 Physician 331 Orthopedic Surgeon Y Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Orthopaedic
Surgery
Adult Reconstructive
Orthopaedic Surgery207XS0114X 31 Physician 331 Orthopedic Surgeon Y Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Orthopaedic
Surgery
Orthopaedic Surgery
of the Spine207XS0117X 31 Physician 331 Orthopedic Surgeon Y Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Orthopaedic
Surgery
Foot and Ankle
Orthopaedics207XX0004X 31 Physician 331 Orthopedic Surgeon Y Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Orthopaedic
SurgerySports Medicine 207XX0005X 31 Physician 331 Orthopedic Surgeon Y Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Orthopaedic
SurgeryOrthopaedic Trauma 207XX0801X 31 Physician 331 Orthopedic Surgeon Y Y
Page 51 of 80
TennCare Taxonomy Crosswalk 7/17/2019
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Otolaryngology Otolaryngology 207Y00000X 31 Physician 332
Otologist,
Laryngologist,
Rhinologist
Y Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
OtolaryngologyPediatric
Otolaryngology207YP0228X 31 Physician 332
Otologist,
Laryngologist,
Rhinologist
Y Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Otolaryngology Sleep Medicine 207YS0012X 31 Physician 332
Otologist,
Laryngologist,
Rhinologist
Y Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Otolaryngology Otolaryngic Allergy 207YX0602X 31 Physician 332
Otologist,
Laryngologist,
Rhinologist
Y Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
OtolaryngologyOtology &
Neurotology207YX0901X 31 Physician 332
Otologist,
Laryngologist,
Rhinologist
Y Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Independent
Medical
Examiner**
Independent Medical
Examiner** 202C00000X 31 Physician 333 Pathologist Y Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Pathology -
Blood Banking &
Transfusion
Medicine
207ZB0001X 31 Physician 333 Pathologist Y Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Pathology - Cytopathology 207ZC0500X 31 Physician 333 Pathologist Y Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Pathology - Clinical Informatics 207ZC0008X 31 Physician 333 Clinical Informatics N Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Pathology - Dermatopathology 207ZD0900X 31 Physician 333 Pathologist Y Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Pathology - Forensic Pathology 207ZF0201X 31 Physician 333 Pathologist Y Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Pathology - Immunopathology 207ZI0100X 31 Physician 333 Pathologist Y Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Pathology -Medical
Microbiology 207ZM0300X 31 Physician 333 Pathologist Y Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Pathology - Neuropathology 207ZN0500X 31 Physician 333 Pathologist Y Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Pathology -Molecular Genetic
Pathology 207ZP0007X 31 Physician 333 Pathologist Y Y
Page 52 of 80
TennCare Taxonomy Crosswalk 7/17/2019
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Pathology - Anatomic Pathology 207ZP0101X 31 Physician 333 Pathologist Y Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Pathology - Chemical Pathology 207ZP0104X 31 Physician 333 Pathologist Y Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Pathology - Pediatric Pathology 207ZP0213X 31 Physician 333 Pathologist Y Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Surgery Pediatric Surgery 2086S0120X 31 Physician 334 Pediatric Surgeon N Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Obstetrics &
Gynecology
Maternal & Fetal
Medicine207VM0101X 31 Physician 335
Maternal Fetal
MedicineN Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Physical Medicine
& Rehabilitation
Physical Medicine &
Rehabilitation 208100000X 31 Physician 336
Physical Medicine and
Rehabilitation
Practitioner
Y Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Physical Medicine
& Rehabilitation
Brain Injury
Medicine2081P0301X 31 Physician 336
Physical Medicine and
Rehabilitation
Practitioner
Y Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Physical Medicine
& Rehabilitation
Hospice and
Palliative
Medicine**
2081H0002X 31 Physician 336
Physical Medicine and
Rehabilitation
Practitioner
Y Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Physical Medicine
& Rehabilitation
Neuromuscular
Medicine**** 2081N0008X 31 Physician 336
Physical Medicine and
Rehabilitation
Practitioner
Y N
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Physical Medicine
& Rehabilitation
Spinal Cord Injury
Medicine 2081P0004X 31 Physician 336
Physical Medicine and
Rehabilitation
Practitioner
Y Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Physical Medicine
& Rehabilitation
Pediatric
Rehabilitation
Medicine
2081P0010X 31 Physician 336
Physical Medicine and
Rehabilitation
Practitioner
Y Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Physical Medicine
& Rehabilitation Pain Medicine 2081P2900X 31 Physician 336
Physical Medicine and
Rehabilitation
Practitioner
Y Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Physical Medicine
& Rehabilitation Sports Medicine 2081S0010X 31 Physician 336
Physical Medicine and
Rehabilitation
Practitioner
Y Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Pain Medicine - Pain Medicine 208VP0000X 31 Physician 336
Physical Medicine and
Rehabilitation
Practitioner
Y Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Pain Medicine -Interventional Pain
Medicine 208VP0014X 31 Physician 336
Physical Medicine and
Rehabilitation
Practitioner
Y Y
Page 53 of 80
TennCare Taxonomy Crosswalk 7/17/2019
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
OtolaryngologyFacial Plastic
Surgery207YS0123X 31 Physician 337 Plastic Surgeon Y Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Otolaryngology
Plastic Surgery
within the Head &
Neck
207YX0007X 31 Physician 337 Plastic Surgeon Y Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
OtolaryngologyOtolaryngology/Faci
al Plastic Surgery207YX0905X 31 Physician 337 Plastic Surgeon Y Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Plastic Surgery Plastic Surgery 208200000X 31 Physician 337 Plastic Surgeon Y Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Plastic Surgery
Plastic Surgery
Within the Head and
Neck
2082S0099X 31 Physician 337 Plastic Surgeon Y Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Surgery
Plastic and
Reconstructive
Surgery
2086S0122X 31 Physician 337 Plastic Surgeon Y Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Colon & Rectal
Surgery
Colon & Rectal
Surgery 208C00000X 31 Physician 338 Proctologist Y Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Psychiatry &
Neurology -
Bariatric
Medicine**** 2084B0002X 31 Physician 339 Psychiatry Y N
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Psychiatry &
Neurology -
Brain Injury
Medicine2084P0301X 31 Physician 339 Psychiatry Y Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Psychiatry &
Neurology -Forensic Psychiatry# 2084F0202X 31 Physician 339 Psychiatrist Y Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Psychiatry &
Neurology -
Hospice and
Palliative
Medicine**
2084H0002X 31 Physician 339 Psychiatrist Y Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Psychiatry &
Neurology -Psychiatry# 2084P0800X 31 Physician 339 Psychiatrist Y Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Psychiatry &
Neurology -
Addiction
Psychiatry# 2084P0802X 31 Physician 339 Psychiatrist Y Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Psychiatry &
Neurology -
Child & Adolescent
Psychiatry#2084P0804X 31 Physician 339 Psychiatrist Y Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Psychiatry &
Neurology -Geriatric Psychiatry# 2084P0805X 31 Physician 339 Psychiatrist Y Y
Page 54 of 80
TennCare Taxonomy Crosswalk 7/17/2019
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Psychiatry &
Neurology
Behavioral
Neurology &
Neuropsychiatry
Speciality
2084B0040X 31 Physician 339 Psychiatrist Y Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Internal Medicine Pulmonary Disease 207RP1001X 31 Physician 340Pulmonary Disease
SpecialistY Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Psychiatry &
Neurology -
Diagnostic
Neuroimaging** 2084D0003X 31 Physician 341 Radiologist Y Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Radiology - Body Imaging 2085B0100X 31 Physician 341 Radiologist Y Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Radiology -Diagnostic
Neuroimaging** 2085D0003X 31 Physician 341 Radiologist Y Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Radiology -
Hospice and
Palliative
Medicine**
2085H0002X 31 Physician 341 Radiologist Y Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Radiology - Neuroradiology 2085N0700X 31 Physician 341 Radiologist Y Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Radiology - Nuclear Radiology 2085N0904X 31 Physician 341 Radiologist Y Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Radiology - Pediatric Radiology 2085P0229X 31 Physician 341 Radiologist Y Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Radiology -Diagnostic
Radiology 2085R0202X 31 Physician 341 Radiologist Y Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Radiology -
Vascular &
Interventional
Radiology
2085R0204X 31 Physician 341 Radiologist Y Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Radiology - Radiological Physics 2085R0205X 31 Physician 341 Radiologist Y Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Radiology -Diagnostic
Ultrasound 2085U0001X 31 Physician 341 Radiologist Y Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Thoracic Surgery
(Cardiothoracic
Vascular Surgery)
Thoracic Surgery
(Cardiothoracic
Vascular Surgery)
208G00000X 31 Physician 342 Thoracic Surgeon Y Y
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Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Urology Urology 208800000X 31 Physician 343 Urologist Y Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Urology Pediatric Urology 2088P0231X 31 Physician 343 Urologist Y Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Urology
Female Pelvic
Medicine and
Reconstructive
Surgery
2088F0040X 31 Physician 343 Urologist Y Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Internal Medicine
Endocrinology,
Diabetes &
Metabolism
207RE0101X 31 Physician 344 General Internist N Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
PeditricsPreventative
Medicine2083B0002X 31 Physician 345 General Pediatrician Y Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
PeditricsPreventative
Medicine2080B0002X 31 Physician 345 General Pediatrician Y Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Pediatrics Pediatrics 208000000X 31 Physician 345 General Pediatrician Y Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Pediatrics Adolescent Medicine 2080A0000X 31 Physician 345 General Pediatrician Y Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Pediatrics
Hospice and
Palliative
Medicine**
2080H0002X 31 Physician 345 General Pediatrician Y Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Pediatrics
Clinical &
Laboratory
Immunology
2080I0007X 31 Physician 345 General Pediatrician Y Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Pediatrics
Developmental –
Behavioral
Pediatrics
2080P0006X 31 Physician 345 General Pediatrician Y Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Pediatrics Neurodevelopmental
Disabilities 2080P0008X 31 Physician 345 General Pediatrician Y Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Pediatrics Pediatric Critical
Care Medicine 2080P0203X 31 Physician 345 General Pediatrician Y Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Pediatrics Pediatric
Endocrinology 2080P0205X 31 Physician 345 General Pediatrician Y Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Pediatrics Pediatric Infectious
Diseases 2080P0208X 31 Physician 345 General Pediatrician Y Y
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TennCare Taxonomy Crosswalk 7/17/2019
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Pediatrics Pediatric
Pulmonology 2080P0214X 31 Physician 345 General Pediatrician Y Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Pediatrics Pediatric
Rheumatology 2080P0216X 31 Physician 345 General Pediatrician Y Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Pediatrics Sports Medicine 2080S0010X 31 Physician 345 General Pediatrician Y Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Pediatrics Sleep Medicine 2080S0012X 31 Physician 345 General Pediatrician Y Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Pediatrics Medical Toxicology 2080T0002X 31 Physician 345 General Pediatrician Y Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Pediatrics Pediatric Transplant
Hepatology****2080T0004X 31 Physician 345 General Pediatrician Y Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Radiology -Therapeutic
Radiology 2085R0203X 31 Physician 347 Radiation Therapist Y Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Neuromusculoskel
etal Medicine &
OMM
Neuromusculoskelet
al Medicine & OMM204D00000X 31 Physician 348
Osteopathic
Manipulative MedicineY Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Pediatrics
Pediatric
Hematology-
Oncology
2080P0207X 31 Physician 349 Pediatric Oncology N Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Internal Medicine Rheumatology 207RR0500X 31 Physician 350 Rheumatologist N Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Radiology - Radiation Oncology 2085R0001X 31 Physician 351 Radiation Oncology Y Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Surgery Surgical Oncology## 2086X0206X 31 Physician 352 Surgical Oncology N Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Obstetrics &
GynecologyGynecology 207VG0400X 31 Physician 353 Gynecologist Y Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Obstetrics &
Gynecology
Gynecologic
Oncology207VX0201X 31 Physician 353 Gynecologist Y Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Obstetrics &
GynecologyObstetrics 207VX0000X 31 Physician 354 Obstetrician Y Y
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TennCare Taxonomy Crosswalk 7/17/2019
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Pathology -Clinical
Pathology**** 207ZC0006X 31 Physician 355 Pathology - Clinical Y N
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Pathology -Anatomic Pathology
& Clinical Pathology 207ZP0102X 31 Physician 355 Pathology - Clinical Y Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Pathology -
Clinical
Pathology/Laborator
y Medicine
207ZP0105X 31 Physician 355 Pathology - Clinical Y Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Anesthesiology Addiction Medicine 207LA0401X 31 Physician 356 Addiction Medicine N Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Family
Medicine+ Addiction Medicine 207QA0401X 31 Physician 356 Addiction Medicine N Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Internal Medicine Addiction Medicine 207RA0401X 31 Physician 356 Addiction Medicine N Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Psychiatry &
Neurology -Addiction Medicine 2084A0401X 31 Physician 356 Addiction Medicine N Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Medical Genetics - Clinical Cytogenetic 207SC0300X 31 Physician 357 Genetics N Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Medical Genetics -Clinical Genetics
(M.D.)207SG0201X 31 Physician 357 Genetics N Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Medical Genetics -Clinical Biochemical
Genetics207SG0202X 31 Physician 357 Genetics N Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Medical Genetics -Clinical Molecular
Genetics207SG0203X 31 Physician 357 Genetics N Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Medical Genetics -Ph.D. Medical
Genetics207SG0205X 31 Physician 357 Genetics N Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Medical Genetics -Molecular Genetic
Pathology207SM0001X 31 Physician 357 Genetics N Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Internal Medicine Hematology 207RH0000X 31 Physician 358 Hematology N Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Pathology - Hematology 207ZH0000X 31 Physician 358 Hematology N Y
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Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Internal Medicine Infectious Disease 207RI0200X 31 Physician 359 Infectious Diseases N Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Internal Medicine Medical Oncology 207RX0202X 31 Physician 365 Oncologist N Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Allergy &
ImmunologyAllergy 207KA0200X 31 Physician 366 Allergist - Pediatric Y Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Pediatrics Pediatric Allergy &
Immunology 2080P0201X 31 Physician 366 Allergist - Pediatric Y Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Anesthesiology Anesthesiology 207L00000X 31 Physician 495Anesthesiologist -
OtherN Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Clinical
Pharmacology
Clinical
Pharmacology 208U00000X 31 Physician 520 Clinical Pharmacology N N
Individual or
Groups (of
Individuals)
Other Service
ProvidersLegal Medicine Legal Medicine 173000000X 31 Physician 530 Legal Medicine N N
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Legal Medicine Legal Medicine 209800000X 31 Physician 530 Legal Medicine N N
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Phlebology** Phlebology** 202K00000X 31 Physician 540 Phlebology N N
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Preventive
Medicine -Addiction Medicine 2083A0300X 31 Physician 671 Addiction Medicine Y Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Internal MedicineCardiovascular
Disease 207RA0002X 31 Physician 672
Adult Congenital Heart
DiseaseY Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Ophthalmology Ophthalmology 207WX0120X 31 Physician 673
Opthamologist Cornea
& External Diseases
Specialist
Y Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Preventive
Medicine -
Public Health &
General Preventive
Medicine
203BP0901N 31 Physician 674
Public Health &
GeneralPreventive
Medicine
Y Y
Individual or
Groups (of
Individuals)
Group Multi-Specialty Multi-Specialty 193200000X 32 Group/Multi-Specialty 082 Medical Clinic Y N
Individual or
Groups (of
Individuals)
Group Single Specialty Single Specialty 193400000X 33 Group/Single-Specialty 150 Chiropractor Y N
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TennCare Taxonomy Crosswalk 7/17/2019
Individual or
Groups (of
Individuals)
Group Single Specialty Single Specialty 193400000X 33 Group/Single-Specialty 190 Optician Y N
Individual or
Groups (of
Individuals)
Group Single Specialty Single Specialty 193400000X 33 Group/Single-Specialty 272 Oral Surgeon Y N
Individual or
Groups (of
Individuals)
Group Single Specialty Single Specialty 193400000X 33 Group/Single-Specialty 310 Allergist Y N
Individual or
Groups (of
Individuals)
Group Single Specialty Single Specialty 193400000X 33 Group/Single-Specialty 311 Anesthesiologist Y N
Individual or
Groups (of
Individuals)
Group Single Specialty Single Specialty 193400000X 33 Group/Single-Specialty 312 Cardiologist Y N
Individual or
Groups (of
Individuals)
Group Single Specialty Single Specialty 193400000X 33 Group/Single-Specialty 313 Cardiovascular Surgeon Y N
Individual or
Groups (of
Individuals)
Group Single Specialty Single Specialty 193400000X 33 Group/Single-Specialty 314 Dermatologist Y N
Individual or
Groups (of
Individuals)
Group Single Specialty Single Specialty 193400000X 33 Group/Single-Specialty 315Emergency Medicine
PractitionerY N
Individual or
Groups (of
Individuals)
Group Single Specialty Single Specialty 193400000X 33 Group/Single-Specialty 316 Family Practitioner Y N
Individual or
Groups (of
Individuals)
Group Single Specialty Single Specialty 193400000X 33 Group/Single-Specialty 317 Gastroenterologist Y N
Individual or
Groups (of
Individuals)
Group Single Specialty Single Specialty 193400000X 33 Group/Single-Specialty 318 General Practitioner Y N
Individual or
Groups (of
Individuals)
Group Single Specialty Single Specialty 193400000X 33 Group/Single-Specialty 319 General Surgeon Y N
Individual or
Groups (of
Individuals)
Group Single Specialty Single Specialty 193400000X 33 Group/Single-Specialty 320 Geriatric Practitioner Y N
Individual or
Groups (of
Individuals)
Group Single Specialty Single Specialty 193400000X 33 Group/Single-Specialty 321 Hand Surgeon Y N
Individual or
Groups (of
Individuals)
Group Single Specialty Single Specialty 193400000X 33 Group/Single-Specialty 322 Internist Y N
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TennCare Taxonomy Crosswalk 7/17/2019
Individual or
Groups (of
Individuals)
Group Single Specialty Single Specialty 193400000X 33 Group/Single-Specialty 323 Neonatologist N N
Individual or
Groups (of
Individuals)
Group Single Specialty Single Specialty 193400000X 33 Group/Single-Specialty 324 Nephrologist Y N
Individual or
Groups (of
Individuals)
Group Single Specialty Single Specialty 193400000X 33 Group/Single-Specialty 325 Neurological Surgeon Y N
Individual or
Groups (of
Individuals)
Group Single Specialty Single Specialty 193400000X 33 Group/Single-Specialty 326 Neurologist Y N
Individual or
Groups (of
Individuals)
Group Single Specialty Single Specialty 193400000X 33 Group/Single-Specialty 327Nuclear Medicine
PractitionerY N
Individual or
Groups (of
Individuals)
Group Single Specialty Single Specialty 193400000X 33 Group/Single-Specialty 328Obstetrician/Gynecolog
istY N
Individual or
Groups (of
Individuals)
Group Single Specialty Single Specialty 193400000X 33 Group/Single-Specialty 329Oncologist (including
Hematology)N N
Individual or
Groups (of
Individuals)
Group Single Specialty Single Specialty 193400000X 33 Group/Single-Specialty 330 Opthamologist Y N
Individual or
Groups (of
Individuals)
Group Single Specialty Single Specialty 193400000X 33 Group/Single-Specialty 331 Orthopedic Surgeon Y N
Individual or
Groups (of
Individuals)
Group Single Specialty Single Specialty 193400000X 33 Group/Single-Specialty 332
Otologist,
Laryngologist,
Rhinologist
Y N
Individual or
Groups (of
Individuals)
Group Single Specialty Single Specialty 193400000X 33 Group/Single-Specialty 333 Pathologist Y N
Individual or
Groups (of
Individuals)
Group Single Specialty Single Specialty 193400000X 33 Group/Single-Specialty 334 Pediatric Surgeon N N
Individual or
Groups (of
Individuals)
Group Single Specialty Single Specialty 193400000X 33 Group/Single-Specialty 335Maternal Fetal
MedicineY N
Individual or
Groups (of
Individuals)
Group Single Specialty Single Specialty 193400000X 33 Group/Single-Specialty 336
Physical Medicine and
Rehabilitation
Practitioner
Y N
Individual or
Groups (of
Individuals)
Group Single Specialty Single Specialty 193400000X 33 Group/Single-Specialty 337 Plastic Surgeon Y N
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TennCare Taxonomy Crosswalk 7/17/2019
Individual or
Groups (of
Individuals)
Group Single Specialty Single Specialty 193400000X 33 Group/Single-Specialty 338 Proctologist Y N
Individual or
Groups (of
Individuals)
Group Single Specialty Single Specialty 193400000X 33 Group/Single-Specialty 339 Psychiatrist Y N
Individual or
Groups (of
Individuals)
Group Single Specialty Single Specialty 193400000X 33 Group/Single-Specialty 340Pulmonary Disease
SpecialistY N
Individual or
Groups (of
Individuals)
Group Single Specialty Single Specialty 193400000X 33 Group/Single-Specialty 341 Radiologist Y N
Individual or
Groups (of
Individuals)
Group Single Specialty Single Specialty 193400000X 33 Group/Single-Specialty 342 Thoracic Surgeon Y N
Individual or
Groups (of
Individuals)
Group Single Specialty Single Specialty 193400000X 33 Group/Single-Specialty 343 Urologist Y N
Individual or
Groups (of
Individuals)
Group Single Specialty Single Specialty 193400000X 33 Group/Single-Specialty 344 General Internist Y N
Individual or
Groups (of
Individuals)
Group Single Specialty Single Specialty 193400000X 33 Group/Single-Specialty 345 General Pediatrician Y N
Individual or
Groups (of
Individuals)
Group Single Specialty Single Specialty 193400000X 33 Group/Single-Specialty 347 Radiation Therapist Y N
Individual or
Groups (of
Individuals)
Group Single Specialty Single Specialty 193400000X 33 Group/Single-Specialty 348Osteopathic
Manipulative MedicineY N
Individual or
Groups (of
Individuals)
Group Single Specialty Single Specialty 193400000X 33 Group/Single-Specialty 349 Pediatric Oncology N N
Individual or
Groups (of
Individuals)
Group Single Specialty Single Specialty 193400000X 33 Group/Single-Specialty 350 Rheumatologist N N
Individual or
Groups (of
Individuals)
Group Single Specialty Single Specialty 193400000X 33 Group/Single-Specialty 351 Radiation Oncology Y N
Individual or
Groups (of
Individuals)
Group Single Specialty Single Specialty 193400000X 33 Group/Single-Specialty 352 Surgical Oncology Y N
Individual or
Groups (of
Individuals)
Group Single Specialty Single Specialty 193400000X 33 Group/Single-Specialty 353 Gynecologist Y N
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TennCare Taxonomy Crosswalk 7/17/2019
Individual or
Groups (of
Individuals)
Group Single Specialty Single Specialty 193400000X 33 Group/Single-Specialty 354 Obstetrician Y N
Individual or
Groups (of
Individuals)
Group Single Specialty Single Specialty 193400000X 33 Group/Single-Specialty 355 Pathology - Clinical Y N
Individual or
Groups (of
Individuals)
Group Single Specialty Single Specialty 193400000X 33 Group/Single-Specialty 356 Addiction Medicine N N
Individual or
Groups (of
Individuals)
Group Single Specialty Single Specialty 193400000X 33 Group/Single-Specialty 357 Genetics N N
Individual or
Groups (of
Individuals)
Group Single Specialty Single Specialty 193400000X 33 Group/Single-Specialty 358 Hematology N N
Individual or
Groups (of
Individuals)
Group Single Specialty Single Specialty 193400000X 33 Group/Single-Specialty 359 Infectious Diseases N N
Individual or
Groups (of
Individuals)
Group Single Specialty Single Specialty 193400000X 33 Group/Single-Specialty 365 Oncologist Y N
Individual or
Groups (of
Individuals)
Group Single Specialty Single Specialty 193400000X 33 Group/Single-Specialty 366 Allergist - Pediatric Y N
Individual or
Groups (of
Individuals)
Group Single Specialty Single Specialty 193400000X 33 Group/Single-Specialty 495Anesthesiologist -
OtherN N
Individual or
Groups (of
Individuals)
Group Single Specialty Single Specialty 193400000X 33 Group/Single-Specialty 520 Clinical Pharmacology N N
Individual or
Groups (of
Individuals)
Group Single Specialty Single Specialty 193400000X 33 Group/Single-Specialty 530 Legal Medicine N N
Individual or
Groups (of
Individuals)
Group Single Specialty Single Specialty 193400000X 33 Group/Single-Specialty 540 Phlebology N N
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Preventive
Medicine -Addiction Medicine 2083A0300X 33 Group/Single-Specialty 671 Addiction Medicine Y Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Internal MedicineCardiovascular
Disease 207RA0002X 33 Group/Single-Specialty 672
Adult Congenital Heart
DiseaseY Y
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Ophthalmology Ophthalmology 207WX0120X 33 Group/Single-Specialty 673
Opthamologist Cornea
& External Diseases
Specialist
Y Y
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Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Preventive
Medicine -
Public Health &
General Preventive
Medicine
203BP0901N 33 Group/Single-Specialty 674
Public Health &
GeneralPreventive
Medicine
Y Y
Individual or
Groups (of
Individuals)
Nursing Service
Related ProvidersChore Provider Chore Provider 372500000X 36 Personal Care Services 360
Personal Care -
IndividualN N
Individual or
Groups (of
Individuals)
Nursing Service
Related Providers
Day
Training/Habilitat
ion Specialist
Day
Training/Habilitation
Specialist
373H00000X 36 Personal Care Services 360Personal Care -
IndividualN N
Individual or
Groups (of
Individuals)
Nursing Service
Related ProvidersTechnician
Personal Care
Attendant 3747P1801X 36 Personal Care Services 360
Personal Care -
IndividualN N
Individual or
Groups (of
Individuals)
Nursing Service
Related ProvidersDoula Doula 374J00000X 36 Personal Care Services 360
Personal Care -
IndividualN N
Individual or
Groups (of
Individuals)
Nursing Service
Related Providers
Religious
Nonmedical
Practitioner
Religious
Nonmedical
Practitioner
374K00000X 36 Personal Care Services 360Personal Care -
IndividualN N
Individual or
Groups (of
Individuals)
Nursing Service
Related Providers
Home Health
Aide Home Health Aide 374U00000X 36 Personal Care Services 360
Personal Care -
IndividualN N
Individual or
Groups (of
Individuals)
Nursing Service
Related ProvidersNurse's Aide Nurse's Aide 376K00000X 36 Personal Care Services 360
Personal Care -
IndividualN N
Non-individual Agencies Nursing Care Nursing Care 251J00000X 36 Personal Care Services 361 Personal Care - Agency N N
Non-individual Agencies Public Health or
Welfare
Public Health or
Welfare 251K00000X 37 Room and Board 370 Room and Board N N
Individual or
Groups (of
Individuals)
Nursing Service
Related Providers
Day
Training/Habilitat
ion Specialist
Day
Training/Habilitation
Specialist
373H00000X 38 Respite Care 380Respite Care -
Community BasedN N
Individual or
Groups (of
Individuals)
Nursing Service
Related Providers
Day
Training/Habilitat
ion Specialist
Day
Training/Habilitation
Specialist
373H00000X 38 Respite Care 381Respite Care - Home
BasedN N
Non-individual Agencies Public Health or
Welfare
Public Health or
Welfare 251K00000X 39 Direct Support Services 390
Habilitation Training
SpecialistN N
Non-individual Agencies Public Health or
Welfare
Public Health or
Welfare 251K00000X 39 Direct Support Services 391 Agency Companion N N
Individual or
Groups (of
Individuals)
Emergency
Medical Service
Providers
Personal
Emergency
Response
Attendant
Personal Emergency
Response Attendant 146D00000X 39 Direct Support Services 392 Daily Living Supports N N
Non-individual Agencies Public Health or
Welfare
Public Health or
Welfare 251K00000X 39 Direct Support Services 392 Daily Living Supports N N
Individual or
Groups (of
Individuals)
Nursing Service
Related ProvidersTechnician
Attendant Care
Provider 3747A0650X 39 Direct Support Services 392 Daily Living Supports N N
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TennCare Taxonomy Crosswalk 7/17/2019
Non-individual Agencies Foster Care
Agency
Foster Care
Agency*****253J00000X 39 Direct Support Services 392 Daily Living Supports N N
Individual or
Groups (of
Individuals)
Other Service
Providers
Prevention
Professional
Prevention
Professional405300000X 39 Direct Support Services 511 Direct Support Services N N
Non-individual Agencies Public Health or
Welfare
Public Health or
Welfare 251K00000X 40
Specialized Foster
Care/MR400
Specialized Foster
Care/MRN N
Non-individual
Ambulatory
Health Care
Facilities
Clinic/Center Adult Day Care 261QA0600X 41 Adult Day Care 410 Adult Day Care N N
Individual or
Groups (of
Individuals)
Nursing Service
Related ProvidersAdult Companion Adult Companion 372600000X 41 Adult Day Care 410 Adult Day Care N N
Individual or
Groups (of
Individuals)
Behavioral Health
& Social Service
Providers
Counselor Counselor 101Y00000X 42Employee Training
Specialist420
Employee Training
SpecialistN N
Individual or
Groups (of
Individuals)
Nursing Service
Related ProvidersHomemaker Homemaker 376J00000X 43 Homemaker Services 430 Homemaker Services N N
Individual or
Groups (of
Individuals)
Other Service
ProvidersContractor Contractor 171W00000X 44
Architectural
Modification440
Architectural
ModificationN N
Individual or
Groups (of
Individuals)
Other Service
ProvidersContractor Home Modifications 171WH0202X 44
Architectural
Modification440
Architectural
ModificationN N
Individual or
Groups (of
Individuals)
Other Service
ProvidersContractor
Vehicle
Modifications 171WV0202X 44
Architectural
Modification440
Architectural
ModificationN N
Non-individual
Residential
Treatment
Facilities
Psychiatric
Residential
Treatment Facility
Psychiatric
Residential
Treatment Facility
323P00000X 45
Residential Behavior
Management Services
(RBMS)
450RBMS Room and
BoardN Y
Non-individual
Residential
Treatment
Facilities
Residential
Treatment
Facility,
Emotionally
Disturbed
Children
Residential
Treatment Facility,
Emotionally
Disturbed Children
322D00000X 45
Residential Behavior
Management Services
(RBMS)
451RBMS Therapeutic
Foster CareN Y
Non-individual Other Service
Providers meals meals 174200000X 46
Advantage Home
Delivered Meal460
Advantage Home
Delivered MealN N
Non-individual Suppliers Home Delivered
Meals
Home Delivered
Meals 332U00000X 46
Advantage Home
Delivered Meal460
Advantage Home
Delivered MealN N
Non-individual
Ambulatory
Health Care
Facilities
Clinic/Center Birthing 261QB0400X 47Free Standing Birthing
Center470
Free Standing Birthing
CenterN Y
Page 65 of 80
TennCare Taxonomy Crosswalk 7/17/2019
Individual or
Groups (of
Individuals)
Nursing Service
Related Providers
Day
Training/Habilitat
ion Specialist
Day
Training/Habilitation
Specialist
373H00000X 48 DDSD-NFM 480 DDSD-NFM N N
Non-individual Agencies Public Health or
Welfare
Public Health or
Welfare 251K00000X 49
DDSD-Supportive
Living Arrangements493
DDSD-Supportive
Living ArrangementsN N
Individual or
Groups (of
Individuals)
Respiratory,
Developmental,
Rehabilitative and
Restorative
Service Providers
Mastectomy Fitter
ClassificationMastectomy Fitter 224900000X 50 Submitter Only 277 Prosthesis N N
Individual or
Groups (of
Individuals)
Respiratory,
Developmental,
Rehabilitative and
Restorative
Service Providers
Pedorthist Pedorthist 224L00000X 50 Submitter Only 277 Prosthesis N N
Individual or
Groups (of
Individuals)
Other Service
ProvidersLodging Lodging 177F00000X 50 Submitter Only 500 State Agency N N
Individual or
Groups (of
Individuals)
Other Service
ProvidersLodging Lodging 177F00000X 50 Submitter Only 501 TPL Carrier N N
Individual or
Groups (of
Individuals)
Other Service
ProvidersLodging Lodging 177F00000X 50 Submitter Only 502 Insurance Carrier N N
Individual or
Groups (of
Individuals)
AgenciesIn Home
Supportive Care Agencies 253Z00000X 51 HCBS Facility 510
HCBS - MR Waiver
FacilityN N
Individual or
Groups (of
Individuals)
Pharmacy Service
Providers
Pharmacy
Technician
Pharmacy
Technician 183700000X 52 Techinician 248 Pharmacy Technician N N
Individual or
Groups (of
Individuals)
Respiratory,
Developmental,
Rehabilitative and
Restorative
Service
Providers+&
Orthotist Orthotist 222Z00000X 52 Techinician 277 Prothesis / Orthotics N N
Individual or
Groups (of
Individuals)
Respiratory,
Developmental,
Rehabilitative and
Restorative
Service
Providers+&
Prosthetist Prosthetist 224P00000X 52 Techinician 277 Prothesis / Orthotics N N
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Individual or
Groups (of
Individuals)
Respiratory,
Developmental,
Rehabilitative and
Restorative
Service
Providers+&
Orthotics/Prosthet
ics Fitter
Orthotics/Prosthetics
Fitter 225000000X 52 Techinician 277 Prothesis / Orthotics N N
Individual or
Groups (of
Individuals)
Technologists,
Technicians &
Other Technical
Service Providers
Technician,
Pathology Phlebotomy 246RP1900X 52 Techinician 540 Phlebology N N
Individual or
Groups (of
Individuals)
Dental ProvidersDental Laboratory
Technician
Dental Laboratory
Technician 126900000X 52 Techinician 552
Dental Laboratory
TechinicianY N
Individual or
Groups (of
Individuals)
Emergency
Medical Service
Providers
Emergency
Medical
Technician, Basic
Emergency Medical
Technician, Basic 146N00000X 52 Techinician 560
Emergency Medical
Technician, BasicN N
Individual or
Groups (of
Individuals)
Emergency
Medical Service
Providers
Emergency
Medical
Technician,
Intermediate
Emergency Medical
Technician,
Intermediate
146M00000X 52 Techinician 561
Emergency Medical
Technician,
Intermediate
N N
Individual or
Groups (of
Individuals)
Emergency
Medical Service
Providers
Emergency
Medical
Technician,
Paramedic
Emergency Medical
Technician,
Paramedic
146L00000X 52 Techinician 562Emergency Medical
Technician, ParamedicN N
Individual or
Groups (of
Individuals)
Nursing Service
Providers
Licensed
Psychiatric
Technician
Licensed Psychiatric
Technician 167G00000X 52 Techinician 570
Licensed Psychiatric
TechinicianN N
Individual or
Groups (of
Individuals)
Nursing Service
Related ProvidersTechnician Technician 374700000X 52 Techinician 580 Nurse Technician N N
Individual or
Groups (of
Individuals)
Technologists,
Technicians &
Other Technical
Service Providers
Technician,
Health
Information
Technician, Health
Information 247000000X 52 Techinician 641
Specialist/Technologist,
Health Information /
Coding Specialist
N N
Individual or
Groups (of
Individuals)
Technologists,
Technicians &
Other Technical
Service Providers
Technician,
Health
Information
Assistant Record
Technician 2470A2800X 52 Techinician 641
Specialist/Technologist,
Health Information /
Coding Specialist
N N
Individual or
Groups (of
Individuals)
Technologists,
Technicians &
Other Technical
Service Providers
Technician,
Pathology
Technician,
Pathology 246R00000X 52 Techinician 643 Pathology N N
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Individual or
Groups (of
Individuals)
Technologists,
Technicians &
Other Technical
Service Providers
Technician,
Cardiology
Technician,
Cardiology 246W00000X 52 Techinician 644 Cardiology N N
Individual or
Groups (of
Individuals)
Technologists,
Technicians &
Other Technical
Service Providers
Technician, Other Biomedical
Engineering 2472B0301X 52 Techinician 645
Biomedical
Engineering N N
Individual or
Groups (of
Individuals)
Technologists,
Technicians &
Other Technical
Service Providers
Technician,
Pathology
Clinical Laboratory
Director, Non
physician**
247ZC0005X 52 Techinician 646Clinical Laboratory
Director, Non physicianN N
Individual or
Groups (of
Individuals)
Technologists,
Technicians &
Other Technical
Service Providers
Technician,
Pathology Histology 246RH0600X 52 Techinician 998
Specialty not yet
definedN N
Individual or
Groups (of
Individuals)
Technologists,
Technicians &
Other Technical
Service Providers
Technician,
Pathology Medical Laboratory 246RM2200X 52 Techinician 998
Specialty not yet
definedN N
Individual or
Groups (of
Individuals)
Technologists,
Technicians &
Other Technical
Service Providers
Technician, Other Darkroom 2472D0500X 52 Techinician 998Specialty not yet
definedN N
Individual or
Groups (of
Individuals)
Technologists,
Technicians &
Other Technical
Service Providers
Technician, Other EEG 2472E0500X 52 Techinician 998Specialty not yet
definedN N
Individual or
Groups (of
Individuals)
Technologists,
Technicians &
Other Technical
Service Providers
Technician, Other Renal Dialysis 2472R0900X 52 Techinician 998Specialty not yet
definedN N
Individual or
Groups (of
Individuals)
Technologists,
Technicians &
Other Technical
Service Providers
Technician, Other Veterinary 2472V0600X 52 Techinician 998Specialty not yet
definedN N
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Individual or
Groups (of
Individuals)
Technologists,
Technicians &
Other Technical
Service Providers
Technician, Other Technician, Other 247200000X 52 Techinician 999 Miscelleneous N N
Individual or
Groups (of
Individuals)
Technologists,
Technicians &
Other Technical
Service Providers
Radiologic
Technologist Mammography 2471M2300X 53 Technologist 292 Mammography N N
Individual or
Groups (of
Individuals)
Respiratory,
Developmental,
Rehabilitative and
Restorative
Service
Providers+&
Pulmonary
Function
Technologist
Pulmonary Function
Technologist 225B00000X 53 Technologist 340
Pulmonary Disease
SpecialistN N
Individual or
Groups (of
Individuals)
Technologists,
Technicians &
Other Technical
Service Providers
Radiologic
Technologist Radiation Therapy 2471R0002X 53 Technologist 347 Radiation Therapist N N
Individual or
Groups (of
Individuals)
Technologists,
Technicians &
Other Technical
Service Providers
Perfusionist** Perfusionist** 242T00000X 53 Technologist 630 Perfusionist N N
Individual or
Groups (of
Individuals)
Technologists,
Technicians &
Other Technical
Service Providers
Radiologic
Technologist
Radiologic
Technologist 247100000X 53 Technologist 631
Radiologic
Technologist N N
Individual or
Groups (of
Individuals)
Technologists,
Technicians &
Other Technical
Service Providers
Radiologic
Technologist Bone Densitometry 2471B0102X 53 Technologist 632 Bone Densitometry N N
Individual or
Groups (of
Individuals)
Technologists,
Technicians &
Other Technical
Service Providers
Radiologic
Technologist
Cardiovascular-
Interventional
Technology
2471C1101X 53 Technologist 633
Cardiac/Cardiovascular-
Interventional
Technology
N N
Individual or
Groups (of
Individuals)
Technologists,
Technicians &
Other Technical
Service Providers
Radiologic
Technologist
Cardiac-
Interventional
Technology
2471C1106X 53 Technologist 633
Cardiac/Cardiovascular-
Interventional
Technology
N N
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Individual or
Groups (of
Individuals)
Technologists,
Technicians &
Other Technical
Service Providers
Radiologic
Technologist
Computed
Tomography 2471C3401X 53 Technologist 634 Computed Tomography N N
Individual or
Groups (of
Individuals)
Technologists,
Technicians &
Other Technical
Service Providers
Radiologic
Technologist
Magnetic Resonance
Imaging 2471M1202X 53 Technologist 635
Magnetic Resonance
Imaging N N
Individual or
Groups (of
Individuals)
Technologists,
Technicians &
Other Technical
Service Providers
Radiologic
Technologist
Nuclear Medicine
Technology 2471N0900X 53 Technologist 636
Nuclear Medicine
Technology N N
Individual or
Groups (of
Individuals)
Technologists,
Technicians &
Other Technical
Service Providers
Radiologic
Technologist Quality Management 2471Q0001X 53 Technologist 637 Quality Management N N
Individual or
Groups (of
Individuals)
Technologists,
Technicians &
Other Technical
Service Providers
Radiologic
Technologist Radiography 2471C3402X 53 Technologist 638 Radiography N N
Individual or
Groups (of
Individuals)
Technologists,
Technicians &
Other Technical
Service Providers
Radiologic
Technologist Sonography 2471S1302X 53 Technologist 639 Sonography / Vascular N N
Individual or
Groups (of
Individuals)
Technologists,
Technicians &
Other Technical
Service Providers
Radiologic
Technologist
Vascular
Sonography 2471V0105X 53 Technologist 639 Sonography / Vascular N N
Individual or
Groups (of
Individuals)
Technologists,
Technicians &
Other Technical
Service Providers
Radiologic
Technologist
Vascular-
Interventional
Technology
2471V0106X 53 Technologist 640Vascular-Interventional
Technology N N
Individual or
Groups (of
Individuals)
Technologists,
Technicians &
Other Technical
Service Providers
Specialist/Technol
ogist, Other Surgical Assistant 246ZC0007X 53 Technologist 647 Certified First Assistant N N
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Individual or
Groups (of
Individuals)
Technologists,
Technicians &
Other Technical
Service Providers
Radiology
Practitioner
Assistant
Radiology
Practitioner
Assistant
243U00000X 54 Assistant 282Radiology Practitioner
AssistantsN N
Individual or
Groups (of
Individuals)
Dental Providers Dental Assistant Dental Assistant 126800000X 54 Assistant 550 Dental Assistant Y N
Individual or
Groups (of
Individuals)
Speech, Language
and Hearing
Service Providers
Specialist/Technol
ogist Audiology Assistant 2355A2700X 54 Assistant 627 Audiology Assistant N N
Individual or
Groups (of
Individuals)
Speech, Language
and Hearing
Service Providers
Specialist/Technol
ogist
Speech-Language
Assistant 2355S0801X 54 Assistant 628
Speech-Language
Assistant N N
Individual or
Groups (of
Individuals)
Dental Providers Dental Hygienist Dental Hygienist 124Q00000X 55 Dental Hygienist 551 Dental Hygienist Y N
Individual or
Groups (of
Individuals)
Nursing Service
Related Providers
Nursing Home
Administrator
Nursing Home
Administrator 376G00000X 56 Administrator 581
Nursing Home
AdministratorN N
Individual or
Groups (of
Individuals)
Other Service
ProvidersHomeopath Homeopath 175L00000X 57 Homeopath 590 Homeopath N N
Individual or
Groups (of
Individuals)
Other Service
ProvidersInterpreter Interpreter 171R00000X 58 Interpreter 591 Interpreter N N
Individual or
Groups (of
Individuals)
Other Service
Providers
Medical Genetics,
Ph.D. Medical
Genetics
Medical Genetics,
Ph.D. Medical
Genetics
170100000X 59Medical Genetics, Non-
physician357 Genetics N N
Individual or
Groups (of
Individuals)
Other Service
ProvidersMidwife, Lay Midwife, Lay 175M00000X 60 Midwife, Lay 592 Non-certified Midwife N N
Individual or
Groups (of
Individuals)
Other Service
Providers
Military Health
Care Provider
Military Health Care
Provider 171000000X 61
Military Health Care
Provider593
Military Health Care
ProviderN N
Individual or
Groups (of
Individuals)
Other Service
Providers
Military Health
Care Provider
Independent Duty
Corpsman 1710I1002X 61
Military Health Care
Provider594
Independent Duty
Corpsman N N
Individual or
Groups (of
Individuals)
Other Service
Providers
Military Health
Care Provider
Independent Duty
Medical Technicians 1710I1003X 61
Military Health Care
Provider595
Independent Duty
Medical Technicians N N
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Electrodiagnostic
Medicine
Electrodiagnostic
Medicine 204R00000X 61
Electrodiagnostic
Medicine Specialist667
Neurophysiologic Tech
SpecialistN N
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Individual or
Groups (of
Individuals)
Other Service
ProvidersNaprapath** Naprapath** 172P00000X 62 Naprapath 596 Naprapath N N
Individual or
Groups (of
Individuals)
Other Service
ProvidersNaturopath Naturopath 175F00000X 63 Naturopath 597 Naturopath N N
Individual or
Groups (of
Individuals)
Other Service
ProvidersSpecialist Graphics Designer 1744G0900X 64 Specialist 598 Graphic Designer N N
Individual or
Groups (of
Individuals)
Other Service
ProvidersSpecialist
Prosthetics Case
Management 1744P3200X 64 Specialist 599
Prosthetics Case
ManagerN N
Individual or
Groups (of
Individuals)
Other Service
ProvidersSpecialist
Research Data
Abstracter/Coder 1744R1103X 64 Specialist 600
Research Data
Abstractor/CoderN N
Individual or
Groups (of
Individuals)
Other Service
ProvidersSpecialist Research Study 1744R1102X 64 Specialist 601 Research Study N N
Individual or
Groups (of
Individuals)
Respiratory,
Developmental,
Rehabilitative and
Restorative
Service
Providers+&
Specialist/Technol
ogist Athletic Trainer 2255A2300X 64 Specialist 623 Athletic Trainer N N
Individual or
Groups (of
Individuals)
Respiratory,
Developmental,
Rehabilitative and
Restorative
Service
Providers+&
Specialist/Technol
ogist Rehabilitation, Blind 2255R0406X 64 Specialist 624 Rehabilitation, Blind N N
Individual or
Groups (of
Individuals)
Speech, Language
and Hearing
Service Providers
Hearing
Instrument
Specialist
Hearing Instrument
Specialist 237700000X 64 Specialist 626
Hearing Instrument
Specialist N N
Individual or
Groups (of
Individuals)
Technologists,
Technicians &
Other Technical
Service Providers
Specialist/Technol
ogist
Cardiovascular
Specialist/Technolog
ist Cardiovascular 246X00000X 64 Specialist 633
Cardiac/Cardiovascular-
Interventional
Technology
N N
Individual or
Groups (of
Individuals)
Technologists,
Technicians &
Other Technical
Service Providers
Specialist/Technol
ogist
Cardiovascular
Cardiovascular
Invasive Specialist 246XC2901X 64 Specialist 633
Cardiac/Cardiovascular-
Interventional
Technology
N N
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Individual or
Groups (of
Individuals)
Technologists,
Technicians &
Other Technical
Service Providers
Specialist/Technol
ogist
Cardiovascular
Vascular Specialist 246XC2903X 64 Specialist 639 Sonography / Vascular N N
Individual or
Groups (of
Individuals)
Technologists,
Technicians &
Other Technical
Service Providers
Specialist/Technol
ogist
Cardiovascular
Sonography 246XS1301X 64 Specialist 639 Sonography / Vascular N N
Individual or
Groups (of
Individuals)
Technologists,
Technicians &
Other Technical
Service Providers
Specialist/Technol
ogist, Health
Information
Specialist/Technolog
ist, Health
Information
246Y00000X 64 Specialist 641
Specialist/Technologist,
Health Information /
Coding Specialist
N N
Individual or
Groups (of
Individuals)
Technologists,
Technicians &
Other Technical
Service Providers
Specialist/Technol
ogist, Health
Information
Coding Specialist,
Hospital Based 246YC3301X 64 Specialist 641
Specialist/Technologist,
Health Information /
Coding Specialist
N N
Individual or
Groups (of
Individuals)
Technologists,
Technicians &
Other Technical
Service Providers
Specialist/Technol
ogist, Health
Information
Coding Specialist,
Physician Office
Based
246YC3302X 64 Specialist 641
Specialist/Technologist,
Health Information /
Coding Specialist
N N
Individual or
Groups (of
Individuals)
Technologists,
Technicians &
Other Technical
Service Providers
Specialist/Technol
ogist, Health
Information
Registered Record
Administrator 246YR1600X 64 Specialist 642
Registered Record
Administrator N N
Individual or
Groups (of
Individuals)
Technologists,
Technicians &
Other Technical
Service Providers
Specialist/Technol
ogist, Pathology
Specialist/Technolog
ist, Pathology 246Q00000X 64 Specialist 643 Pathology N N
Individual or
Groups (of
Individuals)
Technologists,
Technicians &
Other Technical
Service Providers
Specialist/Technol
ogist, Pathology Blood Banking 246QB0000X 64 Specialist 643 Pathology N N
Individual or
Groups (of
Individuals)
Technologists,
Technicians &
Other Technical
Service Providers
Specialist/Technol
ogist, Pathology Chemistry 246QC1000X 64 Specialist 643 Pathology N N
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Individual or
Groups (of
Individuals)
Technologists,
Technicians &
Other Technical
Service Providers
Specialist/Technol
ogist, Pathology Cytotechnology 246QC2700X 64 Specialist 643 Pathology N N
Individual or
Groups (of
Individuals)
Technologists,
Technicians &
Other Technical
Service Providers
Specialist/Technol
ogist, Pathology Hematology 246QH0000X 64 Specialist 643 Pathology N N
Individual or
Groups (of
Individuals)
Technologists,
Technicians &
Other Technical
Service Providers
Specialist/Technol
ogist, Pathology
Hemapheresis
Practitioner 246QH0401X 64 Specialist 643 Pathology N N
Individual or
Groups (of
Individuals)
Technologists,
Technicians &
Other Technical
Service Providers
Specialist/Technol
ogist, Pathology Histology 246QH0600X 64 Specialist 643 Pathology N N
Individual or
Groups (of
Individuals)
Technologists,
Technicians &
Other Technical
Service Providers
Specialist/Technol
ogist, Pathology Immunology 246QI0000X 64 Specialist 643 Pathology N N
Individual or
Groups (of
Individuals)
Technologists,
Technicians &
Other Technical
Service Providers
Specialist/Technol
ogist, Pathology
Laboratory
Management 246QL0900X 64 Specialist 643 Pathology N N
Individual or
Groups (of
Individuals)
Technologists,
Technicians &
Other Technical
Service Providers
Specialist/Technol
ogist, Pathology
Laboratory
Management,
Diplomate
246QL0901X 64 Specialist 643 Pathology N N
Individual or
Groups (of
Individuals)
Technologists,
Technicians &
Other Technical
Service Providers
Specialist/Technol
ogist, Pathology
Medical
Technologist 246QM0706X 64 Specialist 643 Pathology N N
Individual or
Groups (of
Individuals)
Technologists,
Technicians &
Other Technical
Service Providers
Specialist/Technol
ogist, Pathology Microbiology 246QM0900X 64 Specialist 643 Pathology N N
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Individual or
Groups (of
Individuals)
Technologists,
Technicians &
Other Technical
Service Providers
Specialist/Technol
ogist, Other Art, Medical 246ZA2600X 64 Specialist 998
Specialty not yet
definedN N
Individual or
Groups (of
Individuals)
Technologists,
Technicians &
Other Technical
Service Providers
Specialist/Technol
ogist, Other
Biomedical
Engineering 246ZB0301X 64 Specialist 998
Specialty not yet
definedN N
Individual or
Groups (of
Individuals)
Technologists,
Technicians &
Other Technical
Service Providers
Specialist/Technol
ogist, Other
Biomedical
Photographer 246ZB0302X 64 Specialist 998
Specialty not yet
definedN N
Individual or
Groups (of
Individuals)
Technologists,
Technicians &
Other Technical
Service Providers
Specialist/Technol
ogist, Other Biochemist 246ZB0500X 64 Specialist 998
Specialty not yet
definedN N
Individual or
Groups (of
Individuals)
Technologists,
Technicians &
Other Technical
Service Providers
Specialist/Technol
ogist, Other Biostatistician 246ZB0600X 64 Specialist 998
Specialty not yet
definedN N
Individual or
Groups (of
Individuals)
Technologists,
Technicians &
Other Technical
Service Providers
Specialist/Technol
ogist, Other EEG 246ZE0500X 64 Specialist 998
Specialty not yet
definedN N
Individual or
Groups (of
Individuals)
Technologists,
Technicians &
Other Technical
Service Providers
Specialist/Technol
ogist, Other
Electroneurodiagnost
ic 246ZE0600X 64 Specialist 998
Specialty not yet
definedN N
Individual or
Groups (of
Individuals)
Technologists,
Technicians &
Other Technical
Service Providers
Specialist/Technol
ogist, Other Graphics Methods 246ZG0701X 64 Specialist 998
Specialty not yet
definedN N
Individual or
Groups (of
Individuals)
Technologists,
Technicians &
Other Technical
Service Providers
Specialist/Technol
ogist, Other
Geneticist, Medical
(PhD) 246ZG1000X 64 Specialist 998
Specialty not yet
definedN N
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TennCare Taxonomy Crosswalk 7/17/2019
Individual or
Groups (of
Individuals)
Technologists,
Technicians &
Other Technical
Service Providers
Specialist/Technol
ogist, Other Illustration, Medical 246ZI1000X 64 Specialist 998
Specialty not yet
definedN N
Individual or
Groups (of
Individuals)
Technologists,
Technicians &
Other Technical
Service Providers
Specialist/Technol
ogist, Other Nephrology 246ZN0300X 64 Specialist 998
Specialty not yet
definedN N
Individual or
Groups (of
Individuals)
Technologists,
Technicians &
Other Technical
Service Providers
Specialist/Technol
ogist, Other
Surgical
Technologist246ZS0410X 64 Specialist 998
Specialty not yet
definedN N
Individual or
Groups (of
Individuals)
Other Service
ProvidersSpecialist Specialist 174400000X 64 Specialist 999 Miscelleneous N N
Individual or
Groups (of
Individuals)
Respiratory,
Developmental,
Rehabilitative and
Restorative
Service
Providers+&
Specialist/Technol
ogist
Specialist/Technolog
ist 225500000X 64 Specialist 999 Miscelleneous N N
Individual or
Groups (of
Individuals)
Speech, Language
and Hearing
Service Providers
Specialist/Technol
ogist
Specialist/Technolog
ist 235500000X 64 Specialist 999 Miscelleneous N N
Individual or
Groups (of
Individuals)
Technologists,
Technicians &
Other Technical
Service Providers
Specialist/Technol
ogist, Other
Specialist/Technolog
ist, Other 246Z00000X 64 Specialist 999 Miscelleneous N N
Individual or
Groups (of
Individuals)
Pharmacy Service
ProvidersPharmacist Pharmacist 183500000X 65 Pharmacist 241 Pharmacist N N
Individual or
Groups (of
Individuals)
Pharmacy Service
ProvidersPharmacist Ambulatory Care 1835P2201X 65 Pharmacist 241 Pharmacist N Y
Individual or
Groups (of
Individuals)
Pharmacy Service
ProvidersPharmacist
General Practice^^
(use 183500000X)1835G0000X 65 Pharmacist 241 Pharmacist N N
Individual or
Groups (of
Individuals)
Pharmacy Service
ProvidersPharmacist Critical Care 1835C0205X 65 Pharmacist 241 Critical Care Y Y
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TennCare Taxonomy Crosswalk 7/17/2019
Individual or
Groups (of
Individuals)
Pharmacy Service
ProvidersPharmacist Pediatrics 1835P0200X 65 Pharmacist 241 Pediatircs Y Y
Individual or
Groups (of
Individuals)
Pharmacy Service
ProvidersPharmacist Geriatric 1835G0303X 65 Pharmacist 242 Geriatric Pharmacist N N
Individual or
Groups (of
Individuals)
Pharmacy Service
ProvidersPharmacist Nuclear 1835N0905X 65 Pharmacist 243 Nuclear Pharmacist N N
Individual or
Groups (of
Individuals)
Pharmacy Service
ProvidersPharmacist Nutrition Support 1835N1003X 65 Pharmacist 244
Nutrition Support
PharmacistN N
Individual or
Groups (of
Individuals)
Pharmacy Service
ProvidersPharmacist Oncology 1835X0200X 65 Pharmacist 245 Oncology Pharmacist N N
Individual or
Groups (of
Individuals)
Pharmacy Service
ProvidersPharmacist Pharmacotherapy 1835P1200X 65 Pharmacist 246
Pharmacology
PharmacistN N
Individual or
Groups (of
Individuals)
Pharmacy Service
ProvidersPharmacist Psychiatric 1835P1300X 65 Pharmacist 247 Psychiatric Pharmacist N N
Individual or
Groups (of
Individuals)
Pharmacy Service
ProvidersPharmacist
Pharmacist Clinician
(PhC)/ Clinical
Pharmacy
Specialist*****
1835P0018X 65 Pharmacist 520 Clinical Pharmacology N N
Individual or
Groups (of
Individuals)
Respiratory,
Developmental,
Rehabilitative and
Restorative
Service
Providers+&
Anaplastologist Anaplastologist 229N00000X 66 Anaplastologist 277 Prosthesis / Orthotics N N
Individual or
Groups (of
Individuals)
Respiratory,
Developmental,
Rehabilitative and
Restorative
Service
Providers+&
Art Therapist Art Therapist 221700000X 67Therapist - Non-
Certified610 Art Therapist N N
Individual or
Groups (of
Individuals)
Respiratory,
Developmental,
Rehabilitative and
Restorative
Service
Providers+&
Dance Therapist Dance Therapist 225600000X 67Therapist - Non-
Certified611 Dance Therapist N N
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TennCare Taxonomy Crosswalk 7/17/2019
Individual or
Groups (of
Individuals)
Respiratory,
Developmental,
Rehabilitative and
Restorative
Service
Providers+&
Developmental
Therapist**
Developmental
Therapist** 222Q00000X 67
Therapist - Non-
Certified612
Developmental
TherapistN N
Individual or
Groups (of
Individuals)
Respiratory,
Developmental,
Rehabilitative and
Restorative
Service
Providers+&
Kinesiotherapist Kinesiotherapist 226300000X 67Therapist - Non-
Certified613 Kinesiotherapist N N
Individual or
Groups (of
Individuals)
Respiratory,
Developmental,
Rehabilitative and
Restorative
Service
Providers+&
Massage
Therapist Massage Therapist 225700000X 67
Therapist - Non-
Certified614 Massage Therapist N N
Individual or
Groups (of
Individuals)
Respiratory,
Developmental,
Rehabilitative and
Restorative
Service
Providers+&
Music Therapist Music Therapist 225A00000X 67Therapist - Non-
Certified615 Music Therapist N N
Individual or
Groups (of
Individuals)
Respiratory,
Developmental,
Rehabilitative and
Restorative
Service
Providers+&
Recreation
Therapist Recreation Therapist 225800000X 67
Therapist - Non-
Certified616 Recreation Therapist N N
Individual or
Groups (of
Individuals)
Respiratory,
Developmental,
Rehabilitative and
Restorative
Service
Providers+&
Recreation
Therapist
Recreational
Therapist Assistant226000000X 67
Recreational Therapist
Assistant616 Recreation Therapist N N
Individual or
Groups (of
Individuals)
Respiratory,
Developmental,
Rehabilitative and
Restorative
Service
Providers+&
Rehabilitation
Counselor
Assistive
Technology
Practitioner
225CA2400X 68 Counselor 251 Assistive Technology N N
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Individual or
Groups (of
Individuals)
Respiratory,
Developmental,
Rehabilitative and
Restorative
Service
Providers+&
Rehabilitation
Counselor
Rehabilitation
Counselor 225C00000X 68 Counselor 620
Rehabilitation
Counselor N N
Individual or
Groups (of
Individuals)
Respiratory,
Developmental,
Rehabilitative and
Restorative
Service
Providers+&
Rehabilitation
Counselor
Assistive
Technology Supplier 225CA2500X 68 Counselor 621
Assistive Technology
SupplierN N
Individual or
Groups (of
Individuals)
Respiratory,
Developmental,
Rehabilitative and
Restorative
Service
Providers+&
Rehabilitation
Counselor
Orientation and
Mobility Training
Provider
225CX0006X 68 Counselor 622
Orientation and
Mobility Training
Provider
N N
Individual or
Groups (of
Individuals)
Other Service
Providers
Lactation
Consultant, Non-
RN
Lactation
Consultant, Non-RN 174N00000X 68
Lactation Consultant,
Non-RN Counselor665
Lactation Non-RN
CounselorN N
Individual or
Groups (of
Individuals)
Other Service
Providers Clinical Ethicist Clinical Ethicist 174V00000X 68
Clinical Ethicist
Counselor666 Ethics Case consultant N N
Individual or
Groups (of
Individuals)
Student, Health
Care
Student in an
Organized Health
Care
Education/Trainin
g Program
Student in an
Organized Health
Care
Education/Training
Program
390200000X 69 Student, Health Care 629
Student in an
Organized Health Care
Education/Training
Program
N N
Non-individual Managed Care
Organizations
Exclusive
Provider
Organization
Exclusive Provider
Organization 302F00000X 70
Non-capitation
Provider071
Manager Care
Organization (MCO)N N
Non-individual Suppliers Blood Bank Blood Bank 331L00000X 71 Blood Bank 660 Blood Bank N N
Non-individual Suppliers Eye Bank Eye Bank 332G00000X 72 Eye Bank 661 Eye Bank N N
Non-individual Suppliers Non-Pharmacy
Dispensing Site
Non-Pharmacy
Dispensing Site 332900000X 73
Non-Pharmacy
Dispensing Site 662
Non-Pharmacy
Dispensing Site N N
Non-individual Suppliers
Organ
Procurement
Organization
Organ Procurement
Organization 335U00000X 74
Organ Procurement
Organization 663
Organ Procurement
Organization N N
Non-individual Suppliers
Emergency
Response System
Companies
Emergency
Response System
Companies****
333300000X 75Emergency Response
System Companies664
Emergency Response
System CompaniesN N
Individual or
Groups (of
Individuals)
Other Service
Providers
Community
Health Worker
Community Health
Worker****172V00000X 99 Other 187
Community Health -
Non-ProfessionalN N
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Individual or
Groups (of
Individuals)
Other Service
Providers
Health Educator (Weight Watchers)
Health Educator 174H00000X 99 other 511 Health Educator N N
Individual or
Groups (of
Individuals)
Other Service
ProvidersVeterinarian Veterinarian 174M00000X 99 Other 999 Miscelleneous N N
Individual or
Groups (of
Individuals)
Other Service
ProvidersVeterinarian Medical Research 174MM1900X 99 Other 999 Miscelleneous N N
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Other Service
ProvidersPeer Specialist 175T00000X N Other N Miscelleneous N N
Individual or
Groups (of
Individuals)
Technologists,
Technicians &
Other Technical
Service Providers
Specialist/Technol
ogist, Other Orthopedic Assitant 246ZX2200X N Other N Miscelleneous N N
Individual or
Groups (of
Individuals)
Allopathic &
Osteopathic
Physicians
Neurocritcal Care Orthopedic Assitant 2084A2900X N Other N Miscelleneous N N
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