DF-450
type: Organization
node role: treeRoot
id:
  v: DF-450
meta:
  last updated:
    v: 2005-05-10T05:54:54.453+05:30
  profile:
    v: https://docs.mydata.athenahealth.com/fhir-r4/StructureDefinition/athena-pas-requestor-organization-profile
    link: https://docs.mydata.athenahealth.com/fhir-r4/StructureDefinition/athena-pas-requestor-organization-profile
text:
  status:
    v: generated
  div: 1977 NE Foster Blvd Gresham, OR 97030 USA Phone: 5036650999
identifier:
  extension:
    url:
      v: http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-identifierSubDepartment
    value: string
      v: Neighborhood Physicians Practice
  extension:
    url:
      v: http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-identifierJurisdiction
    value: CodeableConcept
  type:
    coding:
      system:
        v: http://terminology.hl7.org/CodeSystem/v2-0203
      code:
        v: NPI
      display:
        v: National Provider Identifier
  system:
    v: http://hl7.org/fhir/sid/us-npi
  value:
    v: 1234567890
identifier:
  type:
    coding:
      system:
        v: http://terminology.hl7.org/CodeSystem/v2-0203
      code:
        v: TIN
      display:
        v: Tax Identification Number
  system:
    v: http://terminology.hl7.org/NamingSystem/USEIN
  value:
    v: 953515524
active:
  v: true
type:
  coding:
    system:
      v: https://codesystem.x12.org/005010/98
    code:
      v: 1T
    display:
      v: Physician, Clinic or Group Practice
  text:
    v: Physician, Clinic or Group Practice
name:
  v: Truman Group Practice
telecom:
  system:
    v: phone
  value:
    v: 9726631212
  use:
    v: work
telecom:
  system:
    v: fax
  value:
    v: 9723332222
address:
  line:
    v: 1977 NE Foster Blvd
  city:
    v: Gresham
  state:
    v: OR
  postal code:
    v: 97030
  country:
    v: USA
contact:
  name:
    text:
      v: Ben Bergeron
    family:
      v: Bergeron
    given:
      v: Ben
  telecom:
    system:
      v: phone
    value:
      v: 5032332233
    use:
      v: work

v: OR

v: Oregon