NPDB and Discipline
How the National Practitioner Data Bank applies to EMS clinicians, how it relates to the National EMS Coordinated Database, and how state EMS officials report disciplinary actions, including action and basis-for-action codes.
The National Practitioner Data Bank (NPDB) is a federal repository that supports quality of care and patient safety by collecting reportable actions related to the professional competence and conduct of health care practitioners, including EMS clinicians. This page explains how the NPDB applies to EMS clinicians, how it relates to the National EMS Coordinated Database, and how state EMS officials report disciplinary actions.
What is the NPDB?
Established by Congress through the Health Care Quality Improvement Act of 1986, the NPDB maintains reports on medical malpractice payments, adverse licensure actions, adverse clinical privileges actions, adverse professional society membership actions, and certain other adjudicated actions or decisions.
Federal Requirements for Licensed Health Professionals
Reporting obligations for licensed professionals, including EMS clinicians, are set out in 45 CFR Part 60 and are implemented by the NPDB under Title IV of the Health Care Quality Improvement Act of 1986 (HCQIA), Public Law 99-660; Section 1921 of the Social Security Act; and Section 1128E of the Social Security Act. See the official NPDB Guidebook for details.
EMS Clinicians and the NPDB
EMS clinicians are subject to the same reporting requirements as other licensed health professionals, including disciplinary actions by a state EMS office; loss, suspension, or revocation of licensure or certification; suspension or revocation of clinical privileges; and other reportable actions that affect professional standing.
Any practitioner, including an EMS clinician, can perform a self-query of the NPDB through the NPDB self-query service, and information on how to dispute a report is available from the NPDB.
The Compact and the National EMS Coordinated Database
The United States EMS Compact requires participating states to report disciplinary actions to the National EMS Coordinated Database (NEMSCD). NEMSCD uses the same data schema conventions as the NPDB to maintain uniform reporting and improve multistate visibility of licensure and discipline for EMS clinicians.
Accurate, timely reporting to the NPDB and NEMSCD promotes public protection and accountability, helps prevent evasion of discipline through relocation, and strengthens coordinated regulation among states.
Reporting Guidance for State EMS Officials
All disciplinary reports must include a factual narrative, at least one action code, and at least one basis-for-action code.
Factual Narrative
Write in objective, concise language. Avoid conclusions not supported by findings. Reference dates, statutes, orders, and outcomes. Do not include protected or sealed information. The following are illustrative examples of licensure actions, bases, and narratives:
| Action taken | Basis for action | Example narrative |
|---|---|---|
| Publicly available negative action or finding | Failure to comply with continuing education; other unprofessional conduct | The state EMS office determined the EMT failed to meet continuing education requirements under state code. The office classified this as unprofessional conduct and issued a public negative finding. |
| Voluntary surrender of license | Unable to practice safely by reason of substance abuse; diversion of controlled substances | During an investigation into alleged diversion for personal use, the paramedic entered into an agreement to voluntarily surrender the license and not reapply for at least two years. |
| Suspension of license; fine or monetary penalty | Criminal conviction; violation of statutes or rules; unethical or unprofessional conduct | Effective on the order date, the EMS board suspended the paramedic license for a minimum of one year, imposed a civil penalty, and required completion of a board-approved professional ethics program following a felony conviction related to EMS practice. |
| Summary or emergency suspension of license | Unable to practice safely by reason of alcohol or other substance abuse | Staff found the EMT unresponsive in a break room. The employer ordered an immediate drug screen, which was positive for opiates without a valid prescription. The EMS office summarily suspended the license pending investigation. |
Avoid an "other" code when a specific code applies. A clear example sentence in an order might read: "Pursuant to the cited sections, the following are reported to NPDB: license action codes 1125 (probation of license) and 1310 (revocation of multi-state licensure privilege); basis codes H4 (inappropriate or unauthorized administration of a medication or sedation) and F6 (substandard or inadequate care)."
Step 1: what action was taken?
NPDB uses "multi-state licensure privilege" terminology. For the EMS Compact, report state-imposed discipline on the Compact Privilege to Practice using the multi-state privilege codes below.
Action codes: license or certification issued by the state
| Code | Description |
|---|---|
| 1110 | Revocation of license |
| 1125 | Probation of license |
| 1135 | Suspension of license |
| 1138 | Summary or emergency limitation or restriction on license |
| 1139 | Summary or emergency suspension of license |
| 1140 | Reprimand or censure |
| 1145 | Voluntary surrender of license |
| 1146 | Voluntary limitation or restriction on license |
| 1147 | Limitation or restriction on license |
| 1148 | Denial of license renewal |
| 1149 | Denial of initial license |
| 1150 | Interim action, voluntary agreement to refrain from practice |
| 1151 | Cease and desist |
| 1155 | Withdrawal of renewal application while under investigation |
| 1173 | Publicly available fine or monetary penalty |
| 1179 | Restriction on ability to prescribe, dispense, or administer medication or sedation |
| 1189 | Publicly available negative action or finding |
| 1199 | Other licensure action, specify |
Action codes: multi-state (Compact) privilege
| Code | Description |
|---|---|
| 1310 | Revocation of multi-state licensure privilege |
| 1325 | Probation of multi-state licensure privilege |
| 1335 | Suspension of multi-state licensure privilege |
| 1338 | Summary or emergency limitation or restriction of multi-state licensure privilege |
| 1339 | Summary or emergency suspension of multi-state licensure privilege |
| 1340 | Reprimand or censure of multi-state licensure privilege |
| 1345 | Voluntary surrender of multi-state licensure privilege |
| 1346 | Voluntary limitation or restriction under multi-state licensure privilege |
| 1347 | Limitation or restriction on multi-state licensure privilege |
| 1351 | Cease and desist, multi-state licensure privilege |
| 1373 | Publicly available fine or monetary penalty, multi-state licensure privilege |
| 1389 | Publicly available negative action or finding, multi-state licensure privilege |
| 1399 | Other action concerning multi-state licensure privilege, specify |
Step 2: Identify up to Five Basis-For-Action Codes
Non-compliance with requirements
| Code | Description |
|---|---|
| 44 | Default on health education loan or scholarship obligations |
| 35 | Drug screening violation |
| A2 | Failure to comply with continuing education or competency requirements |
| 31 | Failure to comply with health and safety requirements |
| 23 | Failure to cooperate with board investigation |
| 50 | Failure to maintain adequate or accurate records |
| 45 | Failure to maintain records or provide required information |
| A3 | Failure to meet board reporting requirements |
| A1 | Failure to meet initial requirements of a license |
| 37 | Failure to pay or delinquent child support |
| 39 | Action by another licensing authority |
| 29 | Practicing beyond scope |
| 24 | Practicing with an expired license |
| 25 | Practicing without a license |
| A4 | Practicing without a valid license |
| A6 | Violation of federal or state statutes, regulations, or rules |
| 36 | Violation of tax code |
| 84 | Violation of state health code |
| A5 | Violation of or failure to comply with board order |
Criminal conviction or adjudication
| Code | Description |
|---|---|
| 19 | Criminal conviction |
| 18 | Deferred adjudication |
| B1 | Nolo contendere plea |
| I1 | Diverted conviction |
Confidentiality, consent, or disclosure
| Code | Description |
|---|---|
| C3 | Breach of confidentiality |
| C2 | Failure to comply with patient consultation requirements |
| C1 | Failure to obtain informed consent |
Misconduct or abuse
| Code | Description |
|---|---|
| D4 | Abusive conduct toward staff |
| D7 | Ethical unfitness |
| D6 | Moral unfitness |
| 71 | Conflict of interest |
| D5 | Disruptive conduct |
| D3 | Exploiting a patient for financial gain |
| 16 | Misappropriation of property |
| D2 | Non-sexual boundary violation |
| 14 | Patient abuse |
| D1 | Sexual misconduct |
| D8 | Other unprofessional conduct, specify |
Fraud, deception, or misrepresentation
| Code | Description |
|---|---|
| E6 | Failure to disclose |
| E3 | Filing false reports or falsifying records |
| 05 | Fraud, unspecified |
| E4 | Fraud or omission in obtaining license or credentials |
| 55 | Improper or abusive billing practices |
| E1 | Insurance fraud |
| E5 | Misleading, false, or deceptive advertising |
| 81 | Misrepresentation of credentials |
| E2 | Providing or ordering unnecessary tests or services |
| 56 | Submitting false claims |
Unsafe practice or substandard care
| Code | Description |
|---|---|
| F8 | Failure to consult or delay in seeking consultation |
| 53 | Failure to provide medically reasonable or necessary items or services |
| F1 | Immediate threat to health or safety |
| 17 | Improper infection control practices |
| FA | Inappropriate refusal to treat |
| 11 | Incompetence |
| 12 | Malpractice |
| 13 | Negligence |
| F9 | Patient abandonment |
| 15 | Patient neglect |
| F6 | Substandard or inadequate care |
| F7 | Substandard or inadequate skill level |
| F5 | Unable to practice safely |
| F2 | Unable to practice safely due to alcohol or substance abuse |
| F4 | Unable to practice safely due to physical illness or impairment |
| F3 | Unable to practice safely due to psychological impairment or mental disorder |
Improper supervision or allowing unlicensed practice
| Code | Description |
|---|---|
| G2 | Allowing or aiding unlicensed practice |
| G1 | Improper or inadequate supervision or delegation |
Improper prescribing, dispensing, or administering medication
| Code | Description |
|---|---|
| H6 | Inappropriate acquisition or diversion of controlled substance |
| H5 | Error in prescribing, dispensing, or administering medication or sedation |
| H1 | Narcotics or other drug statute violation |
| H4 | Inappropriate or unauthorized administration of medication or sedation |
| H3 | Inappropriate or unauthorized dispensing of medication |
| H2 | Inappropriate or unauthorized prescribing of medication |
Other
| Code | Description |
|---|---|
| 99 | Other, not classified, specify |
Revisions to Actions on a State License
These revision codes do not require basis-for-action codes.
| Code | Description |
|---|---|
| 1280 | License restored or reinstated, complete |
| 1282 | License restored or reinstated, conditional |
| 1283 | License restored or reinstated, partial |
| 1285 | License restoration or reinstatement denied |
| 1295 | Reduction of previous licensure action |
| 1296 | Extension of previous licensure action |
| 1297 | Modification of previous licensure action |
Revisions to Actions on Multi-State Privilege
These revision codes do not require basis-for-action codes.
| Code | Description |
|---|---|
| 1480 | Multi-state licensure privilege restored or reinstated, complete |
| 1482 | Multi-state licensure privilege restored or reinstated, conditional |
| 1483 | Multi-state licensure privilege restored or reinstated, partial |
| 1485 | Multi-state licensure privilege restoration or reinstatement denied |
| 1495 | Reduction of previous multi-state licensure privilege action |
| 1496 | Extension of previous multi-state licensure privilege action |
| 1497 | Modification of previous multi-state licensure privilege action |
This page is for educational and informational purposes. State EMS officials must consult the official federal regulations and the United States EMS Compact requirements for complete and current reporting obligations. The NPDB codes shown here are maintained by the federal NPDB and may change; the NPDB Guidebook is the authoritative source. This content is not legal advice.