<?xml version="1.0" encoding="UTF-8"?>

<Organization xmlns="http://hl7.org/fhir">
  <id value="DF-450"/>
  <meta>
    <lastUpdated value="2005-05-10T05:54:54.453+05:30"/>
    <profile value="https://docs.mydata.athenahealth.com/fhir-r4/StructureDefinition/athena-pas-requestor-organization-profile"/>
  </meta>
  <text>
    <status value="generated"/><div xmlns="http://www.w3.org/1999/xhtml"><table width="100%"><tbody><tr><td width="25%"/><td width="42%">1977 NE Foster Blvd Gresham, OR 97030 USA Phone: 5036650999</td></tr></tbody></table></div>
  </text>
  <identifier>
    <extension url="http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-identifierSubDepartment">
      <valueString value="Neighborhood Physicians Practice"/>
    </extension>
    <extension url="http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-identifierJurisdiction">
      <valueCodeableConcept>
        <coding>
          <system value="http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-identifierJurisdiction"/>
          <code value="OR"/>
          <display value="Oregon"/>
        </coding>
      </valueCodeableConcept>
    </extension>
    <type>
      <coding>
        <system value="http://terminology.hl7.org/CodeSystem/v2-0203"/>
        <code value="NPI"/>
        <display value="National Provider Identifier"/>
      </coding>
    </type>
    <system value="http://hl7.org/fhir/sid/us-npi"/>
    <value value="1234567890"/>
  </identifier>
  <identifier>
    <type>
      <coding>
        <system value="http://terminology.hl7.org/CodeSystem/v2-0203"/>
        <code value="TIN"/>
        <display value="Tax Identification Number"/>
      </coding>
    </type>
    <system value="http://terminology.hl7.org/NamingSystem/USEIN"/>
    <value value="953515524"/>
  </identifier>
  <active value="true"/>
  <type>
    <coding>
      <system value="https://codesystem.x12.org/005010/98"/>
      <code value="1T"/>
      <display value="Physician, Clinic or Group Practice"/>
    </coding>
    <text value="Physician, Clinic or Group Practice"/>
  </type>
  <name value="Truman Group Practice"/>
  <telecom>
    <system value="phone"/>
    <value value="9726631212"/>
    <use value="work"/>
  </telecom>
  <telecom>
    <system value="fax"/>
    <value value="9723332222"/>
  </telecom>
  <address>
    <line value="1977 NE Foster Blvd"/>
    <city value="Gresham"/>
    <state value="OR"/>
    <postalCode value="97030"/>
    <country value="USA"/>
  </address>
  <contact>
    <name>
      <text value="Ben Bergeron"/>
      <family value="Bergeron"/>
      <given value="Ben"/>
    </name>
    <telecom>
      <system value="phone"/>
      <value value="5032332233"/>
      <use value="work"/>
    </telecom>
  </contact>
</Organization>