Current through Register Vol. 39, No. 6, September 16, 2024
(a) A physician assistant who has been
licensed, certified, or authorized to practice in at least one other state, the
District of Columbia, U.S. Territory or Canadian province for at least five
years, has been in active clinical practice during the past two years and who
has a clean license application, as defined in Paragraph (c) of this Rule, may
apply for a license on an expedited basis.
(b) In order to apply for an expedited
Physician Assistant License, an applicant shall:
(1) submit a completed application, using the
Board's form, attesting under oath that the information on the application is
true and complete, and authorizing the release to the Board of all information
pertaining to the application;
(2)
submit documentation of a legal name change, if applicable;
(3) on the Board's form, submit a photograph,
at least two inches by two inches, certified as a true likeness of the
applicant by a notary public;
(4)
supply a certified copy of applicant's birth certificate if applicant was born
in the United States or a certified copy of a valid and unexpired US passport.
If the applicant does not possess a certified birth certificate or an unexpired
U.S. passport, the applicant must provide information about applicant's
immigration and work status, which the Board will use to verify applicant's
ability to work lawfully in the United States;
(5) provide a certified copy of any license,
certification or authorization as a physician assistant the applicant has
acquired in at least one other state or jurisdiction for the last five years
immediately preceding this application;
(6) submit proof of achieving a passing score
of completion of the Physician Assistant National Certifying
Examination;
(7) submit proof of
unexpired certification by the National Commission on Certification of
Physician Assistants;
(8) provide
proof of clinical practice, providing patient care for an average of 20 hours
or more per week, for at least the last two years;
(9) submit National Practitioner Data Bank
(NPDB) and Healthcare Integrity and Protection Data Bank (HIPDB) reports. These
reports shall be requested by the applicant and submitted to the Board within
60 days of the request;
(10) submit
a Board Action Data Bank Inquiry report from the Federation of State Medical
Boards (FSMB). This report shall be requested by the applicant and submitted to
the Board within 60 days of the request;
(11) submit to the Board, at P. O. Box 20007,
Raleigh, NC 27619, two complete original fingerprint record cards, on
fingerprint record cards supplied by the Board upon request;
(12) submit to the Board, at P. O. Box 20007,
Raleigh, NC 27619 or license@ncmedboard.org, a signed consent form allowing a
search of local, state, and national files to disclose any criminal
record;
(13) pay to the Board a
non-refundable fee of two hundred thirty dollars ($230.00), as required by
21 NCAC
32S .0202, plus the cost of a criminal
background check;
(14) upon
request, supply any additional information the Board deems necessary to
evaluate the applicant's qualifications.
(c) A clean license application means that
the physician assistant has none of the following:
(1) professional liability insurance claims
or payments;
(2) misdemeanor or
felony conviction;
(3) medical
conditions which could affect the physician assistant's ability to practice
safely;
(4) regulatory board
complaints, investigations, or actions (including applicant's withdrawal of a
license application);
(5) action
taken by a health care institution;
(6) investigations or actions taken by a
federal agency, the US military, medical societies or associations;
or
(7) suspension or expulsion from
any school, including an educational program for physician
assistants.
(d) When
possible, all reports must be submitted to the Board from the entity that
created the report.
(e) All
information required by this Rule shall be provided within one year of
submitting the application.
