Centene FHIR Provider Directory API

The Centene FHIR Provider Directory API exposes in-network provider information for Centene members and the public via HL7 FHIR PDEX Provider Directory resources.

Operations 17

GET /metadata CapailityStatement #
GET /InsurancePlan Search all resources of type InsurancePlan based on a set of criteria #
GET /InsurancePlan/{id} Read the current state of the resource #
GET /Endpoint/{id} Read the current state of the resource #
GET /Endpoint Search all resources of type Endpoint based on a set of criteria #
GET /HealthcareService Search all resources of type HealthcareService based on a set of criteria #
GET /HealthcareService/{id} Read the current state of the resource #
GET /OrganizationAffiliation Search all resources of type OrganizationAffiliation based on a set of criteria #
GET /OrganizationAffiliation/{id} Read the current state of the resource #
GET /Organization Search all resources of type Organization based on a set of criteria #
GET /Organization/{id} Read the current state of the resource #
GET /PractitionerRole Search all resources of type PractitionerRole based on a set of criteria #
GET /PractitionerRole/{id} Read the current state of the resource #
GET /Practitioner Search all resources of type Practitioner based on a set of criteria #
GET /Practitioner/{id} Read the current state of the resource #
GET /Location Search all resources of type Location based on a set of criteria #
GET /Location/{id} Read the current state of the resource #

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OpenAPI Specification

centene-fhir-provider-directory-openapi.json Raw ↑
{
  "openapi": "3.0.1",
  "info": {
    "title": "Provider Directory",
    "description": "Provider directory endpoints for FHIR resources",
    "version": "1.0"
  },
  "servers": [
    {
      "url": "https://dev-int-api-gw.centene.com/fhir/v4/providerdirectory"
    }
  ],
  "tags": [
    {
      "name": "HealthcareService"
    },
    {
      "name": "InsurancePlan"
    },
    {
      "name": "Location"
    },
    {
      "name": "Organization"
    },
    {
      "name": "OrganizationAffiliation"
    },
    {
      "name": "Practitioner"
    },
    {
      "name": "PractitionerRole"
    },
    {
      "name": "Endpoint"
    },
    {
      "name": "metadata"
    }

  ],
  "paths": {
    "/metadata": {
      "get": {
        "tags": [
          "metadata"
        ],
        "summary": "CapailityStatement",
        "description": "Capability Statement",
        "operationId": "getMetadata",
        "responses": {
          "200": {
            "description": "Success"
          }
        }
      }
    },
    "/InsurancePlan": {
      "get": {
        "tags": [
          "InsurancePlan"
        ],
        "summary": "Search all resources of type InsurancePlan based on a set of criteria",
        "operationId": "searchInsurancePlan",
        "parameters": [
          {
            "name": "administered-by",
            "in": "query",
            "description": "Product administrator",
            "schema": {
              "type": "string"
            }
          },
          {
            "name": "coverage-area",
            "in": "query",
            "schema": {
              "type": "string"
            }
          },
          {
            "name": "identifier",
            "in": "query",
            "description": "Any identifier for the organization (not the accreditation issuer's identifier)",
            "schema": {
              "type": "string"
            }
          },
          {
            "name": "_lastUpdated",
            "in": "query",
            "schema": {
              "type": "string",
              "format": "date"
            }
          },
          {
            "name": "name",
            "in": "query",
            "description": "A portion of the organization's name or alias",
            "schema": {
              "type": "string"
            }
          },
          {
            "name": "name:contains",
            "in": "query",
            "description": "Contains a portion of the organization's name or alias",
            "schema": {
              "type": "string"
            }
          },
          {
            "name": "name:exact",
            "in": "query",
            "description": "An exact organization's name or alias",
            "schema": {
              "type": "string"
            }
          },
          {
            "name": "owned-by",
            "in": "query",
            "description": "An organization of which this organization forms a part",
            "schema": {
              "type": "string"
            }
          },
          {
            "name": "plan-type",
            "in": "query",
            "schema": {
              "type": "string"
            }
          },
          {
            "name": "plan-type:text",
            "in": "query",
            "schema": {
              "type": "string"
            }
          },
          {
            "name": "type",
            "in": "query",
            "description": "A code for the type of organization",
            "schema": {
              "type": "string"
            }
          },
          {
            "name": "identifier:text",
            "in": "query",
            "schema": {
              "type": "string"
            }
          },
          {
            "name": "type:text",
            "in": "query",
            "schema": {
              "type": "string"
            }
          },
          {
            "name": "_id",
            "in": "query",
            "description": "The ID of the resource",
            "schema": {
              "type": "string"
            }
          },
          {
            "name": "_include",
            "in": "query",
            "schema": {
              "type": "string",
              "x-consoleDefault": "application/json"
            },
            "x-consoleDefault": "application/json"
          },
          {
            "name": "_source",
            "in": "query",
            "schema": {
              "type": "string"
            }
          },
          {
            "name": "_next",
            "in": "query",
            "schema": {
              "type": "string"
            }
          },
          {
            "name": "_page",
            "in": "query",
            "schema": {
              "type": "number"
            }
          }
        ],
        "responses": {
          "200": {
            "description": "Success",
            "content": {
              "*/*": {
                "schema": {
                  "$ref": "#/components/schemas/InsurancePlan-search"
                }
              }
            }
          },
          "400": {
            "description": "Bad request",
            "content": {
              "*/*": {
                "example": {
                  "resourceType": "OperationOutcome",
                  "issue": [
                    {
                      "severity": "error",
                      "code": "invalid",
                      "details":{
                        "text": "Invalid or badly formed InsurancePlan ID ."
                      }
                    } ]
                },
                "schema": {
                  "$ref": "#/components/schemas/GeneralError"
                }
              }
            }
          },
          "401": {
            "description": "Unauthorized",
            "content": {
              "*/*": {
                "schema": {
                  "$ref": "#/components/schemas/GeneralError"
                },
                "example": {
                  "resourceType": "OperationOutcome",
                  "issue": [
                    {
                      "severity": "error",
                      "code": "Unauthorized",
                      "details":{
                        "text": "You are not authorized to view this InsurancePlan."
                      }
                    } ]
                }
              }
            }
          },
          "403": {
            "description": "Forbidden",
            "content": {
              "*/*": {
                "schema": {
                  "$ref": "#/components/schemas/GeneralError"
                },
                "example": {
                  "resourceType": "OperationOutcome",
                  "issue": [
                    {
                      "severity": "error",
                      "code": "forbidden",
                      "details":{
                        "text": "You are not allowed to view this InsurancePlan."
                      }
                    }
                  ]
                }
              }
            }
          },
          "404": {
            "description": "Not Found",
            "content": {
              "*/*": {
                "schema": {
                  "$ref": "#/components/schemas/GeneralError"
                },
                "example": {
                  "resourceType": "OperationOutcome",
                  "issue": [
                    {
                      "severity": "error",
                      "code": "Not Found",
                      "details":{
                        "text": "No InsurancePlan found with the provided ID."
                      }
                    }
                  ]
                }
              }
            }
          },
          "500": {
            "description": "InternalServerError",
            "content": {
              "*/*": {
                "schema": {
                  "$ref": "#/components/schemas/GeneralError"
                },
                "example": {
                  "resourceType": "OperationOutcome",
                  "issue": [
                    {
                      "severity": "fatal",
                      "code": "exception",
                      "details":{
                        "text": "Internal server error. Please try again later"
                      }
                    }
                  ]
                }
              }
            }
          },
          "429": {
            "description": "Too Many Requests",
            "content": {
              "*/*": {
                "schema": {
                  "$ref": "#/components/schemas/GeneralError"
                },
                "example": {
                  "resourceType": "OperationOutcome",
                  "issue": [
                    {
                      "severity": "error",
                      "code": "Too Many Requests",
                      "details":{
                        "text": "Too Many Requests for InsurancePlan with the provided ID."
                      }
                    }
                  ]
                }
              }
            }
          },
          "501": {
            "description": "Not Implemented",
            "content": {
              "*/*": {
                "schema": {
                  "$ref": "#/components/schemas/GeneralError"
                },
                "example": {
                  "resourceType": "OperationOutcome",
                  "issue": [
                    {
                      "severity": "error",
                      "code": "Not Implemented",
                      "details":{
                        "text": "The request for InsurancePlan is Not Implemented"
                      }
                    }
                  ]
                }
              }
            }
          },
          "502": {
            "description": "Bad gateway",
            "content": {
              "*/*": {
                "schema": {
                  "$ref": "#/components/schemas/GeneralError"
                },
                "example": {
                  "resourceType": "OperationOutcome",
                  "issue": [
                    {
                      "severity": "error",
                      "code": "Bad gateway",
                      "details":{
                        "text": "Bad gateway"
                      }
                    }
                  ]
                }
              }
            }
          },
          "503": {
            "description": "Service Unavailable",
            "content": {
              "*/*": {
                "schema": {
                  "$ref": "#/components/schemas/GeneralError"
                },
                "example": {
                  "resourceType": "OperationOutcome",
                  "issue": [
                    {
                      "severity": "error",
                      "code": "Service Unavailable",
                      "details":{
                        "text": "Service Unavailable"
                      }
                    }
                  ]
                }
              }
            }
          },
          "504": {
            "description": "Gateway Timeout",
            "content": {
              "*/*": {
                "schema": {
                  "$ref": "#/components/schemas/GeneralError"
                },
                "example": {
                  "resourceType": "OperationOutcome",
                  "issue": [
                    {
                      "severity": "error",
                      "code": "Gateway Timeout",
                      "details":{
                        "text": "Gateway Timeout"
                      }
                    }
                  ]
                }
              }
            }

        }
        },
        "security": [
          {
            "Basic": []
          }
        ]
      }
    },

    "/InsurancePlan/{id}": {
      "get": {
        "tags": [
          "InsurancePlan"
        ],
        "summary": "Read the current state of the resource",
        "operationId": "readInsurancePlan",
        "parameters": [
          {
            "name": "id",
            "in": "path",
            "required": true,
            "schema": {
              "type": "string"
            }
          }
        ],
        "responses": {
          "200": {
            "description": "Success",
            "content": {
              "*/*": {
                "schema": {
                  "$ref": "#/components/schemas/InsurancePlan"
                }
              }
            }
          },
          "400": {
            "description": "Bad request",
            "content": {
              "*/*": {
                "example": {
                  "resourceType": "OperationOutcome",
                  "issue": [
                    {
                      "severity": "error",
                      "code": "invalid",
                      "details":{
                        "text": "Invalid or badly formed InsurancePlan ID ."
                      }
                    } ]
                },
                "schema": {
                  "$ref": "#/components/schemas/GeneralError"
                }
              }
            }
          },
          "401": {
            "description": "Unauthorized",
            "content": {
              "*/*": {
                "schema": {
                  "$ref": "#/components/schemas/GeneralError"
                },
                "example": {
                  "resourceType": "OperationOutcome",
                  "issue": [
                    {
                      "severity": "error",
                      "code": "Unauthorized",
                      "details":{
                        "text": "You are not authorized to view this InsurancePlan."
                      }
                    } ]
                }
              }
            }
          },
          "403": {
            "description": "Forbidden",
            "content": {
              "*/*": {
                "schema": {
                  "$ref": "#/components/schemas/GeneralError"
                },
                "example": {
                  "resourceType": "OperationOutcome",
                  "issue": [
                    {
                      "severity": "error",
                      "code": "forbidden",
                      "details":{
                        "text": "You are not allowed to view this InsurancePlan."
                      }
                    }
                  ]
                }
              }
            }
          },
          "404": {
            "description": "Not Found",
            "content": {
              "*/*": {
                "schema": {
                  "$ref": "#/components/schemas/GeneralError"
                },
                "example": {
                  "resourceType": "OperationOutcome",
                  "issue": [
                    {
                      "severity": "error",
                      "code": "Not Found",
                      "details":{
                        "text": "No InsurancePlan found with the provided ID."
                      }
                    }
                  ]
                }
              }
            }
          },
          "500": {
            "description": "InternalServerError",
            "content": {
              "*/*": {
                "schema": {
                  "$ref": "#/components/schemas/GeneralError"
                },
                "example": {
                  "resourceType": "OperationOutcome",
                  "issue": [
                    {
                      "severity": "fatal",
                      "code": "exception",
                      "details":{
                        "text": "Internal server error. Please try again later"
                      }
                    }
                  ]
                }
              }
            }
          },
          "429": {
            "description": "Too Many Requests",
            "content": {
              "*/*": {
                "schema": {
                  "$ref": "#/components/schemas/GeneralError"
                },
                "example": {
                  "resourceType": "OperationOutcome",
                  "issue": [
                    {
                      "severity": "error",
                      "code": "Too Many Requests",
                      "details":{
                        "text": "Too Many Requests for InsurancePlan with the provided ID."
                      }
                    }
                  ]
                }
              }
            }
          },
          "501": {
            "description": "Not Implemented",
            "content": {
              "*/*": {
                "schema": {
                  "$ref": "#/components/schemas/GeneralError"
                },
                "example": {
                  "resourceType": "OperationOutcome",
                  "issue": [
                    {
                      "severity": "error",
                      "code": "Not Implemented",
                      "details":{
                        "text": "The request for InsurancePlan is Not Implemented"
                      }
                    }
                  ]
                }
              }
            }
          },
          "502": {
            "description": "Bad gateway",
            "content": {
              "*/*": {
                "schema": {
                  "$ref": "#/components/schemas/GeneralError"
                },
                "example": {
                  "resourceType": "OperationOutcome",
                  "issue": [
                    {
                      "severity": "error",
                      "code": "Bad gateway",
                      "details":{
                        "text": "Bad gateway"
                      }
                    }
                  ]
                }
              }
            }
          },
          "503": {
            "description": "Service Unavailable",
            "content": {
              "*/*": {
                "schema": {
                  "$ref": "#/components/schemas/GeneralError"
                },
                "example": {
                  "resourceType": "OperationOutcome",
                  "issue": [
                    {
                      "severity": "error",
                      "code": "Service Unavailable",
                      "details":{
                        "text": "Service Unavailable"
                      }
                    }
                  ]
                }
              }
            }
          },
          "504": {
            "description": "Gateway Timeout",
            "content": {
              "*/*": {
                "schema": {
                  "$ref": "#/components/schemas/GeneralError"
                },
                "example": {
                  "resourceType": "OperationOutcome",
                  "issue": [
                    {
                      "severity": "error",
                      "code": "Gateway Timeout",
                      "details": {
                        "text": "Gateway Timeout"
                      }
                    }
                  ]
                }
              }
            }
          }
          },
        "security": [
          {
            "Basic": []
          }
        ]
      }
    },

    "/Endpoint/{id}": {
      "get": {
        "tags": [
          "Endpoint"
        ],
        "summary": "Read the current state of the resource",
        "operationId": "readEndpoint",
        "parameters": [
          {
            "name": "id",
            "in": "path",
            "required": true,
            "schema": {
              "type": "string"
            }
          }
        ],
        "responses": {
          "200": {
            "description": "Success",
            "content": {
              "*/*": {
                "schema": {
                  "$ref": "#/components/schemas/Endpoint"
                }
              }
            }
          },
          "400": {
            "description": "Bad request",
            "content": {
              "*/*": {
                "example": {
                  "resourceType": "OperationOutcome",
                  "issue": [
                    {
                      "severity": "error",
                      "code": "invalid",
                      "details":{
                        "text": "Invalid or badly formed Endpoint ID ."
                      }
                    } ]
                },
                "schema": {
                  "$ref": "#/components/schemas/GeneralError"
                }
              }
            }
          },
          "401": {
            "description": "Unauthorized",
            "content": {
              "*/*": {
                "schema": {
                  "$ref": "#/components/schemas/GeneralError"
                },
                "example": {
                  "resourceType": "OperationOutcome",
                  "issue": [
                    {
                      "severity": "error",
                      "code": "Unauthorized",
                      "details":{
                        "text": "You are not authorized to view this Endpoint."
                      }
                    } ]
                }
              }
            }
          },
          "403": {
            "description": "Forbidden",
            "content": {
              "*/*": {
                "schema": {
                  "$ref": "#/components/schemas/GeneralError"
                },
                "example": {
                  "resourceType": "OperationOutcome",
                  "issue": [
                    {
                      "severity": "error",
                      "code": "forbidden",
                      "details":{
                        "text": "You are not allowed to view this Endpoint."
                      }
                    }
                  ]
                }
              }
            }
          },
          "404": {
            "description": "Not Found",
            "content": {
              "*/*": {
                "schema": {
                  "$ref": "#/components/schemas/GeneralError"
                },
                "example": {
                  "resourceType": "OperationOutcome",
                  "issue": [
                    {
                      "severity": "error",
                      "code": "Not Found",
                      "details":{
                        "text": "No Endpoint found with the provided ID."
                      }
                    }
                  ]
                }
              }
            }
          },
          "500": {
            "description": "InternalServerError",
            "content": {
              "*/*": {
                "schema": {
                  "$ref": "#/components/schemas/GeneralError"
                },
                "example": {
                  "resourceType": "OperationOutcome",
                  "issue": [
                    {
                      "severity": "fatal",
                      "code": "exception",
                      "details":{
                        "text": "Internal server error. Please try again later"
                      }
                    }
                  ]
                }
              }
            }
          },
          "429": {
            "description": "Too Many Requests",
            "content": {
              "*/*": {
                "schema": {
                  "$ref": "#/components/schemas/GeneralError"
                },
                "example": {
                  "resourceType": "OperationOutcome",
                  "issue": [
                    {
                      "severity": "error",
                      "code": "Too Many Requests",
                      "details":{
                        "text": "Too Many Requests for Endpoint with the provided ID."
                      }
                    }
                  ]
                }
              }
            }
          },
          "501": {
            "description": "Not Implemented",
            "content": {
              "*/*": {
                "schema": {
                  "$ref": "#/components/schemas/GeneralError"
                },
                "example": {
                  "resourceType": "OperationOutcome",
                  "issue": [
                    {
                      "severity": "error",
                      "code": "Not Implemented",
                      "details":{
                        "text": "The request for Endpoint is Not Implemented"
                      }
                    }
                  ]
                }
              }
            }
          },
          "502": {
            "description": "Bad gateway",
            "content": {
              "*/*": {
                "schema": {
                  "$ref": "#/components/schemas/GeneralError"
                },
                "example": {
                  "resourceType": "OperationOutcome",
                  "issue": [
                    {
                      "severity": "error",
                      "code": "Bad gateway",
                      "details":{
                        "text": "Bad gateway"
                      }
                    }
                  ]
                }
              }
            }
          },
          "503": {
            "description": "Service Unavailable",
            "content": {
              "*/*": {
                "schema": {
                  "$ref": "#/components/schemas/GeneralError"
                },
                "example": {
                  "resourceType": "OperationOutcome",
                  "issue": [
                    {
                      "severity": "error",
                      "code": "Service Unavailable",
                      "details":{
                        "text": "Service Unavailable"
                      }
                    }
                  ]
                }
              }
            }
          },
          "504": {
            "description": "Gateway Timeout",
            "content": {
              "*/*": {
                "schema": {
                  "$ref": "#/components/schemas/GeneralError"
                },
                "example": {
                  "resourceType": "OperationOutcome",
                  "issue": [
                    {
                      "severity": "error",
                      "code": "Gateway Timeout",
                      "details": {
                        "text": "Gateway Timeout"
                      }
                    }
                  ]
                }
              }
            }
          }
          }
      }
    },

    "/Endpoint": {
      "get": {
        "tags": [
          "Endpoint"
        ],
        "summary": "Search all resources of type Endpoint based on a set of criteria",
        "operationId": "searchEndpoint",
        "parameters": [
          {
            "name": "_lastUpdated",
            "in": "query",
            "schema": {
              "type": "string",
              "format": "date"
            }
          },

          {
            "name": "_id",
            "in": "query",
            "description": "The ID of the resource",
            "schema": {
              "type": "string"
            }
          },
          {
            "name": "organization",
            "in": "query",
            "description": "The organization that provides this Endpoint Service",
            "schema": {
              "type": "string"
            }
          },
          {
            "name": "_include",
            "in": "query",
            "schema": {
              "type": "string",
              "x-consoleDefault": "application/json"
            },
            "x-consoleDefault": "application/json"
          }
        ],
        "responses": {
          "200": {
            "description": "Success",
            "content": {
              "*/*": {
                "schema": {
                  "$ref": "#/components/schemas/Endpoint-search"
                }
              }
            }
          },
          "400": {
            "description": "Bad request",
            "content": {
              "*/*": {
                "example": {
                  "resourceType": "OperationOutcome",
                  "issue": [
                    {
                      "severity": "error",
                      "code": "invalid",
                      "details":{
                        "text": "Invalid or badly formed Endpoint ID ."
                      }
                    } ]
                },
                "schema": {
                  "$ref": "#/components/schemas/GeneralError"
                }
              }
            }
          },
          "401": {
            "description": "Unauthorized",
            "content": {
              "*/*": {
                "schema": {
                  "$ref": "#/components/schemas/GeneralError"
                },
                "example": {
                  "resourceType": "OperationOutcome",
                  "issue": [
                    {
                      "severity": "error",
                      "code": "Unauthorized",
                      "details":{
                        "text": "You are not authorized to view this Endpoint."
                      }
                    } ]
                }
              }
            }
          },
          "403": {
            "description": "Forbidden",
            "content": {
              "*/*": {
                "schema": {
                  "$ref": "#/components/schemas/GeneralError"
                },
                "example": {
                  "resourceType": "OperationOutcome",
                  "issue": [
                    {
                      "severity": "error",
                      "code": "forbidden",
                      "details":{
                        "text": "You are not allowed to view this Endpoint."
                      }
                    }
                  ]
                }
              }
            }
          },
          "404": {
            "description": "Not Found",
            "content": {
              "*/*": {
                "schema": {
                  "$ref": "#/components/schemas/GeneralError"
                },
                "example": {
                  "resourceType": "OperationOutcome",
                  "issue": [
                    {
                      "severity": "error",
                      "code": "Not Found",
                      "details":{
                        "text": "No Endpoint found with the provided ID."
                      }
                    }
                  ]
                }
              }
            }
          },
          "500": {
            "description": "InternalServerError",
            "content": {
              "*/*": {
                "schema": {
                  "$ref": "#/components/schemas/GeneralError"
                },
                "example": {
                  "resourceType": "OperationOutcome",
                  "issue": [
                    {
                      "severity": "fatal",
                      "code": "exception",
                      "details":{
                        "text": "Internal server error. Please try again later"
                      }
                    }
                  ]
                }
              }
            }
          },
          "429": {
            "description": "Too Many Requests",
            "content": {
              "*/*": {
                "schema": {
                  "$ref": "#/components/schemas/GeneralError"
                },
                "example": {
                  "resourceType": "OperationOutcome",
                  "issue": [
                    {
                      "severity": "error",
                      "code": "Too Many Requests",
                      "details":{
                        "text": "Too Many Requests for Endpoint with the provided ID."
                      }
                    }
                  ]
                }
              }
            }
          },
          "501": {
            "description": "Not Implemented",
            "content": {
              "*/*": {
                "schema": {
                  "$ref": "#/components/schemas/GeneralError"
                },
                "example": {
                  "resourceType": "OperationOutcome",
                  "issue": [
                    {
                      "severity": "error",
                  

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# Full source: https://raw.githubusercontent.com/api-evangelist/centene/refs/heads/main/openapi/centene-fhir-provider-directory-openapi.json