GAPNA Section Research brief: National Provider Identifier database: Can it be a useful workforce tool? Debra Bakerjian, PhD, RN, FNP, Kathy Speegle-Clark, MS(c), BSN, RN, Eduard Poltaviskiy, BS, Chin-Shang Li, PhD 1. Background The U.S. Census Bureau predicts the number of older adults will more than double in the next 20 years. Our ability to meet the health care demands of this population with more chronic illnesses is dependent upon adequate geriatric trained providers, yet accu- rately identifying the geriatric workforce is challenging. Past methods have relied upon surveys of professional organization and labor force statistics. Validity of these workforce estimates has been questioned because of individual inconsistencies in identifying a geriatric specialty, inherent problems of self-reported data, and lack of data from groups such as self-employed persons or those not certified but working in the industry. 1 As many advanced practice nurses are aware, each of us who provide Medicare or Medicaid services have been required to enter information into a national registry system in order to be a provider for Medicare or Medicaid patients. This registry, the National Provider Identifier (NPI) database 2 is a searchable, online, HIPAA compliant public registry of all provider organizations and clini- cians who provide Medicare and Medicaid services, available since September 2007. The registry provides a 10 digit unique identifi- cation number that replaces provider social security numbers that were previously used as identifiers. The main purpose of the NPI database is to be able to identify all clinical and institutional providers and link through this unique identification number for purposes of payment and provides a taxonomy to identify provider specialty. The NPI registry includes data for almost 3.5 million providers of which 2.6 million are clinicians. Historically, we have used data from a variety of sources to determine the geriatric workforce. Typically, surveys such as the National Sample Survey of Registered Nurse that is conducted every four years by Health Resources and Services Administration (HRSA) along with professional organization surveys, have been used to provide information about the nurse workforce. Unfortunately, these have not been very effective in identifying the geriatric advanced practice nurse (APN) workforce that works in nursing homes. 3 2. Purpose of study We conducted a study of the NPI database to analyze whether the NPI database could do a better job of identifying the APN workforce than traditional survey methods. We hypothesized the database may be a more accurate source of identifying geriatric workforce data when compared with professional organizations that rely upon sample surveys and Bureau of Labor Statistics that uses multiple data sources for estimates. Hypothesis of increased accuracy comes from regulatory requirements to use the NPI identifier for payment, provides specific field such as licensure and certification, that there are prescribed taxonomies that each clini- cian or provider organization must identify with, and that the downloadable file contains only active data. 3. Methods We developed a unique algorithm for the NPI database in order to identify geriatric clinicians and applied this series of screens to the database. This brief report highlights just the information on individual APNs that provide care to older adults. In this process we first targeted APNs who self-identified as geriatric trained, added those APNs who chose a geriatric taxonomy, and then added those who identified with a geriatric organizational provider. Once we had that list, we deleted all duplicates. We conducted a cross sectional analysis of the data to hone in on the number of APNs providing geriatric care. 4. Results Initial results were reported at the 2012 American Public Health Association conference in San Francisco. Table 1 shows just the findings for APNs providing care to older adults. We identified 2522 unique APNs who are clearly providing care to older adults, most (n ¼ 2065) were gerontological nurse practitioners (GNPs) with the others as either adult or primary care NPs. Only 7 APNs identified themselves as being in long-term care. Unfortunately, it was not as good a source of identifying geriatric APN workforce as we pre- dicted; however, we were able to identify important issues related to the use of the NPI database that may prove useful for the future. Contents lists available at SciVerse ScienceDirect Geriatric Nursing journal homepage: www.gnjournal.com 0197-4572/$ e see front matter Ó 2013 Mosby, Inc. All rights reserved. http://dx.doi.org/10.1016/j.gerinurse.2013.02.007 Geriatric Nursing 34 (2013) 162e165