| Component# | Type | Description |
| #1 | [FN] | family name (last name) |
| #2 | [ST] | given name (first name) |
| #3 | [ST] | middle initial or name |
| #4 | [ST] | suffix (jr, sr, etc) |
| #5 | [ST] | prefix (Mr, Mrs, Dr etc) |
| #6 | [IS] | degree (MD, PHD etc) |
| #7 | [ID] | name type code |
| #8 | [ID] | Name Representation Code |
| #9 | [CE] | Name Context |
| #10 | [DR] | Name Validity Range |
| #11 | [ID] | Name Assembly Order |
| #12 | [TS] | Effective Date |
| #13 | [TS] | Expiration Date |
| #14 | [ST] | Professional Suffix |