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clinical nurse specialist, workforce, national provider identifier



  1. Reed, Sean M. PhD, APRN, ACNS-BC, ACHPN
  2. Arbet, Jaron PhD
  3. Staubli, Linda MSN, RN, CCRN-K, ACCNS-AG


Purpose/Aims: This study illuminates the workforce of the clinical nurse specialist (CNS), using data from the National Provider Identifier (NPI) registry.


Design: This is a descriptive exploratory study using CNSs' self-reported data within the NPI registry through December 2019.


Methods: Tabulations for frequencies of available demographics, population foci/specialty, and tests for differences in urban/rural locations were conducted. Clinical nurse specialists practicing as nurse practitioners were also counted and identified. Run charts were used to assess quarterly trends for CNSs obtaining new NPIs.


Results: Ten thousand CNSs were registered with an NPI, and 9470 reported 1 population foci/specialty. Furthermore, 1932 CNSs (19.3%) also report working as a nurse practitioner. Only 2 CNS specialties differed by more than 4% between urban and rural areas (respectively): family health (7.7% and 15.5%) and CNSs without a specialty (17.1% and 12.6%). Run charts identified 5 specialties with changing trends in new NPI enumerations (family health, adult-gero, postacute care, pediatrics, and women's health).


Conclusions: Of the estimated 89 122 CNSs in the United States, only 11.2% of the CNS workforce was described and accounted for within the NPI registry. Clinical nurse specialists are encouraged to register for an NPI. Further research is necessary to describe the location and type of work CNSs are performing within the US healthcare system.