You can use WITH XMLNAMESPACES .
WITH XMLNAMESPACES(DEFAULT 'urn:hl7-org:v3')
SELECT
Field.value('title[1]', 'varchar(255)') AS Title,
Field.value('(recordTarget/patientRole/id/@extension)[1]', 'varchar(255)') AS InternalPatientID,
Field.value('(effectiveTime/@value)[1]', 'varchar(255)') AS CreationDateTime,
Field.value('(recordTarget/patientRole/patient/name/name)[1]', 'varchar(255)') AS FullName,
Field.value('(recordTarget/patientRole/patient/name/family)[1]', 'varchar(255)') AS LastName,
Field.value('(recordTarget/patientRole/patient/name/given)[1]', 'varchar(255)') AS FirstName,
Field.value('(recordTarget/patientRole/patient/name/given)[2]', 'varchar(255)') AS MiddleName,
Field.value('(recordTarget/patientRole/patient/birthTime/@value)[1]', 'varchar(255)') AS DateOfBirth,
Field.value('(recordTarget/patientRole/patient/administrativeGenderCode/@code)[1]', 'varchar(255)') AS Gender,
Field.value('(recordTarget/patientRole/addr/streetAddressLine)[1]', 'varchar(255)') AS PatientAddress,
Field.value('(recordTarget/patientRole/addr/streetAddressLine)[2]', 'varchar(255)') AS PatientAddress2,
Field.value('(recordTarget/patientRole/addr/city)[1]', 'varchar(255)') AS PatientCity,
Field.value('(recordTarget/patientRole/addr/state)[1]', 'varchar(255)') AS PatientState,
Field.value('(recordTarget/patientRole/addr/postalCode)[1]', 'varchar(255)') AS PatientZip,
Replace(Field.value('(recordTarget/patientRole/telecom/@value)[1]', 'varchar(255)'), 'tel:', '') AS HomePhone
FROM @ClinicalDocumentXml.nodes('ClinicalDocument') CCD(Field)
You can also make it a little shorter using cross apply.
WITH XMLNAMESPACES(DEFAULT 'urn:hl7-org:v3')
SELECT
CD.Field.value('title[1]', 'varchar(255)') AS Title,
PR.Field.value('(id/@extension)[1]', 'varchar(255)') AS InternalPatientID,
CD.Field.value('(effectiveTime/@value)[1]', 'varchar(255)') AS CreationDateTime,
PR.Field.value('(patient/name/name)[1]', 'varchar(255)') AS FullName,
PR.Field.value('(patient/name/family)[1]', 'varchar(255)') AS LastName,
PR.Field.value('(patient/name/given)[1]', 'varchar(255)') AS FirstName,
PR.Field.value('(patient/name/given)[2]', 'varchar(255)') AS MiddleName,
PR.Field.value('(patient/birthTime/@value)[1]', 'varchar(255)') AS DateOfBirth,
PR.Field.value('(patient/administrativeGenderCode/@code)[1]', 'varchar(255)') AS Gender,
PR.Field.value('(addr/streetAddressLine)[1]', 'varchar(255)') AS PatientAddress,
PR.Field.value('(addr/streetAddressLine)[2]', 'varchar(255)') AS PatientAddress2,
PR.Field.value('(addr/city)[1]', 'varchar(255)') AS PatientCity,
PR.Field.value('(addr/state)[1]', 'varchar(255)') AS PatientState,
PR.Field.value('(addr/postalCode)[1]', 'varchar(255)') AS PatientZip,
Replace(PR.Field.value('(telecom/@value)[1]', 'varchar(255)'), 'tel:', '') AS HomePhone
FROM
(SELECT @ClinicalDocumentXml.query('/ClinicalDocument/*')) AS CD(Field)
CROSS APPLY
(SELECT CD.Field.query('recordTarget/patientRole/*')) AS PR(Field)