| Seq | Description | German Interpretation | Length | C.LEN | Table | r/o/c | Rep# | Item | Data Structure | Section | 
| 1 | Provider Role | Art der Beziehung zum Leistungserbringer (Rolle) | 
 | 
 | 0286 | R | Y | 01155 | CWE | 11.8.3.1 | 
| 2 | Provider Name | Name des Leistungserbringers | 
 | 
 | 
 | O | Y | 01156 | XPN | 11.8.3.2 | 
| 3 | Provider Address | Adresse des Leistungserbringers | 
 | 
 | 
 | O | Y | 01157 | XAD | 11.8.3.3 | 
| 4 | Provider Location | Lokalisation des Leistungserbringers | 
 | 
 | 
 | O | 
 | 01158 | PL | 11.8.3.4 | 
| 5 | Provider Communication Information | Telekommunikationshinweise | 
 | 
 | 
 | O | Y | 01159 | XTN | 11.8.3.5 | 
| 6 | Preferred Method of Contact | Am besten erreichbar über | 
 | 
 | 0185 | O | 
 | 00684 | CWE | 11.8.3.6 | 
| 7 | Provider Identifiers | ID des Leistungserbringers (z.B. IKZ / Arztnummer) | 
 | 
 | 0338 | O | Y | 01162 | PLN | 11.8.3.7 | 
| 8 | Effective Start Date of Provider Role | gültig ab bezogen auf Datenelement 01155 | 
 | 
 | 
 | O | 
 | 01163 | DTM | 11.8.3.8 | 
| 9 | Effective End Date of Provider Role | gültig bis bezogen auf Datenelement 01155 | 
 | 
 | 
 | O | Y | 01164 | DTM | 11.8.3.9 | 
| 10 | Provider Organization Name and Identifier | 
 | 
 | 
 | 
 | O | N | 02256 | XON | 11.8.3.10 | 
| 11 | Provider Organization Address | 
 | 
 | 
 | 
 | O | Y | 02257 | XAD | 11.8.3.11 | 
| 12 | Provider Organization Location Information | 
 | 
 | 
 | 
 | O | Y | 02258 | PL | 11.8.3.12 | 
| 13 | Provider Organization Communication Information | 
 | 
 | 
 | 
 | O | Y | 02259 | XTN | 11.8.3.13 | 
| 14 | Provider Organization Method of Contact | 
 | 
 | 
 | 0185 | O | N | 02260 | CWE | 11.8.3.14 |