Definitions

A health care practitioner, licensed health care practitioner, licensed practitioner, or practitioner, as used in this Guidebook, is defined as an individual who is licensed or otherwise authorized by a state to provide health care services; or any individual who, without authority, holds himself or herself out to be so licensed or authorized. See Table C-1, parts 1 and 2.

A dentist is defined as a doctor of dental surgery, dental medicine, or the equivalent who is legally authorized to practice dentistry by a state, or any individual who, without authority, holds himself or herself out to be so authorized.

A physician is defined as a doctor of medicine or osteopathy legally authorized to practice medicine or surgery by a state, or any individual who, without authority, holds himself or herself out to be so authorized.

A health care entity means:

For purposes of the second bullet of this definition, an entity includes a health maintenance organization (HMO) that is licensed by a state or determined to be qualified as such by the Department of Health and Human Services (HHS), and any group or prepaid medical or dental practice that meets the criteria of the second bullet.

A formal peer review process is the conduct of professional review activities through formally adopted written procedures that provide for adequate notice and an opportunity for a hearing.

A health care provider means:

A health care supplier means:

Table C-1 lists examples of health care practitioners. Table C-2 offers examples of health care entities, providers, and suppliers. Table C-3 provides a summary of reporting requirements and query access for the NPDB.