no taxonomy code 339-Lodging Providers 393-Provide Meals 357-Community/Behavioral Health 060-Early Intervention; Provider Agency

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1 PROVIDER TYPE CODE PROVIDER SPECIALTY CODE TAXONOMY CODE 335-Case Manager/Care Coordinator 171M00000X 468-County Social Service Office 171M00000X 017-Other Service 339-Lodging Providers 393-Provide Meals 035-Case Management 357-Community/Behavioral Health 060-Early Intervention; Provider Agency 251B00000X 251S00000X 252Y00000X 025-Agenices 082-Home Health Agency 251E00000X 454- Hospice Care, Community Based 251G00000X 453-Human Service Center 251S00000X 397-Local Education Agency (LEA)/Special Education X 358-PACE 251T00000X 261-Public Health or Welfare 251K00000X 026-Ambulatory Health Care Facilities 026-Adolescent and Children Mental Health 070-Adult Mental Health 089-Ambulatory Surgical Center 071-Augmentative Communication 359-Clinic/Center 040-Community Health Centers 437-Dental Clinic 271-Emergency Care 300-End-Stage Renal Disease Treatment (ESRD) 299-Endoscopy 015-Family Planning Non-Surgical 361-Federally Qualified Health Center 332-Hearing & Speech 186-Infusion Therapy 395-Magnetic Resonance Imaging (MRI) 360-Mental Health (Incl. Comm Mntl Hlth) 406-Migrant Health 408-Occupational Medicine 261QM0855X 261QM0850X 261QA1903X 261QA3000X 261Q00000X 261QC1500X 261QD0000x 261QE0002X 261QE0700X 261QE0800X 261QF0050X 261QF0400X 261QH0700X 261QI0500X 261QM1200X 261QM0801X 261QM1000X 261QX0100X

2 026-Ambulatory Health Care Facilities 107-Oncology 409-Oncology, Radiation 410-Ophthalmologic Surgery 212-Oral Maxillofacial Surgery 218-Pain Management 110-Physical Therapy 048-Podiatric 413-Primary Care 416-Public Health, State or Local 030-Radiology 417-Radiology, Mammography 418-Radiology, Mobile 419-Radiology, Mobile Mammography 420-Rehabilitation 422-Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) 364-Rehabilitation, Substance Use Disorder Unit 423-Rehabilitation, Cardiac Facilities 268-Rural Health Clinic 424-Sleep Disorder Diagnostic 426-Student Health 288-Urgent Care Center 261QX0200X 261QX0203X 261QS0132X 261QS0112X 261QP3300X 261QP2000X 261QP1100X 261QP2300X 261QP0905X 261QR0200X 261QR0206X 261QR0208X 261QR0207X 261QR0400X 261QR0401X 261QR0405X 261QR0404X 261QR1300X 261QS1200X 261QS1000X 261QU0200X 027-Hospital Units 362-Psychiatric Unit; Hospital Unit 363-Rehabilitation Unit; Hospital Unit 364-Rehabilitation, Substance Use Disorder Unit 196-Swingbed (Medicare Defined) 273R00000X 273Y00000X X 275N00000X 028-Hospitals 156-Chronic Disease Hospital 111-Critical Access: Hospital 091-General Acute Care Hospital 192-Long Term Care Hospital 131-Psychiatric Hospital 421-Rehabilitation Hospital 281P00000X 282NC0060X 282N00000X 282E00000X 283Q00000X 283X00000X

3 029-Laboratories 054-Clinical Medical Lab 366-Physiological Lab (Ind Physiological Lab) 291U00000X 293D00000X 030-Managed Care Organizations 367-Health Maintenance Organization 302R00000X 031-Nursing & Custodial Care Facilities 371-Alzheimer/Dementia/ Dementia Care X 440 -Basic Care in a Nursing Facility 311Z00000X 370-Custodial Care Facility 311Z00000X 438 -Gero Psych Nursing Home X 369-Intermediate Care Facility-MR 315P00000X 439-Non Gero Psych Nursing Home X 269-Skilled Nursing Facility X 032-Residential Treatment Facilities 258-Psychiatric Residential Treatment Facility 264-RTF, Emotionally Disturbed Children 265-RTF, Mental Retardation and/or DD 266-RTF, Physical Disabilities 274-Substance Abuse Disorder Treatment Facility 427-Substance Abuse Treatment, Children 323P00000X 322D00000X X X X 3245S0500X 033-Suppliers 472-Clinic Pharmacy 473-Community/Retail Pharmacy 474-Compounding Pharmacy 113-Durable Medical Equipment & Medical Suppliers 384-Eyewear Supplier 383-Hearing Aid Equipment 475-Home Infusion Therapy Pharmacy X 3336C0003X 3336C0004X 332B00000X 332H00000X 332S00000X 3336H0001X 486-Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy X

4 033-Suppliers 476-Institutional Pharmacy 477-Long Term Care Pharmacy 478-Mail Order Pharmacy 479-Managed Care Organization Pharmacy 480-Non-Pharmacy Dispensing Site 481-Nuclear Pharmacy 128-Pharmacy 116-Portable X-Ray Supplier 347-Prosthetic/Orthotic Supplier 482-Specialty Pharmacy 3336I0012X 3336L0003X 3336M0002X 3336M0003X X 3336N0007X X 335V00000X 335E00000X 3336S0011X 034-Transportation Services 483-Air Carrier 132-Ambulance 385-Bus 387-Private Vehicle 388-Secured Medical Transport (Van) 389-Taxi 390-Train 484-Transportation Broker X X 347B00000X 347C00000X X X 347D00000X 347E00000X 039-Developmental Disabilities 335-Case Manager/Care Coordinator 380-Congregate Care (DD) 374-Day Support (DD) 373-Extended Services (DD) 379-Family Support Services (DD) 377-Ind Supp Lvg Arrangement (DD) 372-Infant Development (DD) 381-Minimally Suprvsd Lvg Arrngmnt (DD) 382-Supported Living Arrangement (DD) 376-Transitional Comm Living Facility (DD)

5 043-Basic Care 079-Basic Care Facility 370-Custodial Care Facility 311Z00000X 311Z00000X 047-Indian Health Services 132-Ambulance 359-Clinic/Center 300-End Stage Renal Dialysis (ESRD) Treatment 091-General Acute Care Hospital X 261Q00000X 261QE0700X 282N00000X 048-Qualified Service Providers 323-Adult Day Care 318-Adult Family Foster Care 146-Attendant Care 312-Case Management Assment 313-Case Management Other 309-Chore Labor 308-Chore Snow Removal 153-Chore Emrgncy Rspns Sys Comp 321-Environmental Modifications 394-Extended Personal Care 319-Family Home Care 112-Family Personal Care 317-Higher Lvl Case Mgmt Assmnt 316-Higher Lvl Case Mgmt Other 330-Home Delivered Meals 180-Homemaker

6 048-Qualified Service Providers 310-Installation ERS 205-Non-Med Transport (Carrier-bus, taxi) 327-Non-Med Transport (Escort) 326-Non-Med Transport (local-round trip) 325-Non-Med Transport (out of town) 396-Nurse Education Care 209-Nurse Management 249-Personal Care 320-Personal Care Assisted Living 251-Personal Care Daily Rate 399-Personal Care Unit Rate 324-Residential Service 081-Respite Care 306-Respite Care, Institutional 125-Specialized Equipment 285-TBI Case Management Other 286-TBI Case Management Team Meeting 287-TBI Supportive Employment 314-Tech Depd Case Mgmt Other 315-Tech Depd Case Mgmt Asmt 329-Transitional Living

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