Organization — Healthcare legal entity

Hospital, laboratory, group practice, insurer, public payor, pharmacy, software vendor. Any structure referenced by another FHIR resource flows through Organization.

Purpose of the resource

Organization models any healthcare legal entity (legal or virtual): hospital, clinic, GHT, laboratory, pharmacy, medical practice, insurer, public payor (Social Security, Medicare, NHS), distributor, manufacturer, software vendor, care team.

Organization is the pivot for structure modelling: every Practitioner may be affiliated to several Organizations (via PractitionerRole), every Coverage references an insurer (Organization), every DiagnosticReport references a laboratory (Organization). Hierarchy is handled by partOf (a hospital department belongs to a hospital that belongs to a group).

Key fields

National identifiers

JSON example

Hopital Universitaire Paris 1 organisation, identified by FINESS 750100018 and US NPI (for international flows), part of AP-HP, exposing a FHIR R5 endpoint:

{
  "resourceType": "Organization",
  "id": "hosp-paris-1",
  "identifier": [{
    "use": "official",
    "type": {
      "coding": [{
        "system": "http://terminology.hl7.org/CodeSystem/v2-0203",
        "code": "PRN",
        "display": "Provider number"
      }]
    },
    "system": "http://ans.fr/finess",
    "value": "750100018"
  }, {
    "use": "secondary",
    "system": "http://hl7.org/fhir/sid/us-npi",
    "value": "1234567890"
  }],
  "active": true,
  "type": [{
    "coding": [{
      "system": "http://terminology.hl7.org/CodeSystem/organization-type",
      "code": "prov",
      "display": "Healthcare Provider"
    }]
  }],
  "name": "Hopital Universitaire Paris 1",
  "alias": ["HUP1"],
  "contact": [{
    "purpose": {
      "coding": [{
        "system": "http://terminology.hl7.org/CodeSystem/contactentity-type",
        "code": "ADMIN"
      }]
    },
    "name": {
      "family": "Martin",
      "given": ["Sophie"]
    },
    "telecom": [{
      "system": "phone",
      "value": "+33 1 42 00 00 00",
      "use": "work"
    }, {
      "system": "email",
      "value": "contact@hup1.fr"
    }],
    "address": {
      "line": ["1 boulevard de l'Hopital"],
      "city": "Paris",
      "postalCode": "75013",
      "country": "FR"
    }
  }],
  "endpoint": [{
    "reference": "Endpoint/hup1-fhir-r5"
  }],
  "partOf": {
    "reference": "Organization/aphp"
  }
}

• identifier[0]: official FINESS (use=official).
• identifier[1]: secondary NPI for US exchanges.
• type: prov = Healthcare Provider.
• contact: one administrative contact (Sophie Martin) with phone, e-mail and postal address.
• endpoint: reference to the site's FHIR R5 Endpoint (URL + auth in Endpoint).
• partOf: belongs to Organization/aphp (Assistance Publique – Hopitaux de Paris).

REST API

• GET /Organization?identifier=http://ans.fr/finess|750100018 — search by FINESS.
• GET /Organization?type=prov&active=true — active providers.
• GET /Organization?partof=Organization/aphp — every structure belonging to AP-HP.
• GET /Organization?_include=Organization:endpoint — organisation + its endpoints.
• POST /Organization — create.
• GET /Organization?address-city=Paris&_count=20 — pagination.

Profiles

Common pitfalls

• Identifier without system — a bare FINESS, without the URI http://ans.fr/finess, is ambiguous for cross-region servers. Always qualify with the canonical system.
• Incomplete hierarchy — for hospital groups (French GHT, US IDN), omitting partOf prevents analytical rollups and group searches.
• Several Organizations for the same facility — creating one Organization per integration flow instead of unifying via national identifiers breaks the providers index.
• Endpoint without Authentication — referencing an open endpoint without documenting authentication in the referenced Endpoint misleads clients.
• Confusion with Location — Organization = legal entity, Location = physical place. A hospital (Organization) has multiple Locations (departments, floors, rooms).

Related resources

• Practitioner / PractitionerRole — affiliated professionals.
• Location — attached physical places.
• Patient — patient managed by this Organization (managingOrganization).
• OrganizationAffiliation — cross-organisation relationships.
• Endpoint — exposed technical endpoints.
• InsurancePlan — issued insurance plan.
• HealthcareService — offered services.