{
  "slug": "practitioner-phone-reachability",
  "title": "Practitioner phone-number reachability",
  "hypotheses": [
    "H43"
  ],
  "status": "published",
  "release_date": "2026-08-20",
  "generated_at": "2026-09-21T16:12:10+00:00",
  "methodology_version": "0.7.2-draft",
  "commit_sha": "7fa80d8",
  "headline": "Of 7,373,232 active Practitioner resources in the 2026-08-20 NDH release, 7,371,320 (99.974%) can be associated with at least one phone number through FHIR. Where does that phone live? 7,371,292 (99.974%) carry a phone directly on the Practitioner record; 2,103,410 (28.5%) have one on PractitionerRole; 2,015,393 (27.3%) reach one via a traversed Location. 28 of the 7,371,320 are reachable ONLY by traversing role or location (i.e. the Practitioner record itself does not carry a phone). 1,912 (0.026%) have no phone on any of the three resources.",
  "numerator": 7371320,
  "denominator": 7373232,
  "chart": {
    "type": "bar",
    "unit": "count",
    "data": [
      {
        "label": "Phone on Practitioner record",
        "value": 7371292
      },
      {
        "label": "Phone only via role / location",
        "value": 28
      },
      {
        "label": "No phone on any path",
        "value": 1912
      }
    ]
  },
  "notes": "Three resolution paths, evaluated independently then unioned: (1) Practitioner.telecom (system='phone'); (2) PractitionerRole.telecom on any active role whose practitioner reference resolves to this NPI; (3) Location.telecom on any Location referenced by such a role (PractitionerRole.location -> Location). The union is intersected with the active Practitioner set, so the numerator never exceeds the denominator and dangling references drop out. Per-path reachability at the practitioner level: 7,371,292 via Practitioner, 2,103,410 via PractitionerRole, 2,015,393 via traversed Location. Seven-region overlap across {P, R, L}: P-only 5,250,254, R-only 0, L-only 28, P\u2229R 105,673, P\u2229L 17,628, R\u2229L 0, P\u2229R\u2229L 1,997,737, none 1,912. On-record contact points break down as: phone 7,371,292, fax 2,960,152, email 0, url 0; 7,371,452 active practitioners carry any telecom entry at all on the Practitioner resource. Before de-duplication against the active set, 2,103,410 practitioner references are reachable via a role-level phone and 2,015,393 via a location-level phone. Caveat \u2014 the May 2026-05-08 release deduped Location resources sharply (-61% vs April), which mechanically lowers path-3 reachability relative to the April release; compare across releases with that in mind. Upstream context: NPPES (the source of ~90% of these fields) keeps practice phone on the practice location, not the individual, so a sparse Practitioner.telecom is expected and is not itself a data quality defect \u2014 the operational takeaway is that a 'call this provider' feature must read PractitionerRole/Location, not Practitioner.telecom alone. Full Venn breakdown with raw counts at /api/v1/findings/practitioner-phone-reachability-detail.json."
}