01042

Study Authorizing Provider

2003-08-22
Definition: This field contains the healthcare provider, generally the attending physician, who is accountable that the patient is eligible for the trial and has signed an informed consent. National standard healthcare provider codes should be used when they exist. This field is required for the patient registration trigger event (C01).
Length≤250
23 components
1O-ID Number
2O-Family Name
3O-Given Name
4O-Second and Further Given Names or Initials Thereof
5O-Suffix (e.g., JR or III)
6O-Prefix (e.g., DR)
7BDegree (e.g., MD)
8CSource Table
9OAssigning Authority
10OName Type Code
11O-Identifier Check Digit
12CCheck Digit Scheme
13OIdentifier Type Code
14O-Assigning Facility
15OName Representation Code
16OName Context
17B-Name Validity Range
18OName Assembly Order
19O-Effective Date
20O-Expiration Date
21O-Professional Suffix
22O-Assigning Jurisdiction
23O-Assigning Agency or Department