21 NCAC 32S .0220 EXPEDITED APPLICATION FOR PHYSICIAN ASSISTANT LICENSURE
(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 email@example.com, 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.
History Note: Authority G.S. 90-9.3; 90-13.1;
Eff. November 1, 2010;
Pursuant to G.S. 150B-21.3A rule is necessary without substantive public interest Eff. March 1, 2016;
Amended Eff. April 1, 2019.