North Carolina Administrative Code › Title 21 - OCCUPATIONAL LICENSING BOARDS AND COMMISSIONS › Chapter 32 - NORTH CAROLINA MEDICAL BOARD › Subchapter S - PHYSICIAN ASSISTANTS › Section .0200 - PHYSICIAN ASSISTANT REGISTRATION › Section 32S .0220 - EXPEDITED APPLICATION FOR PHYSICIAN ASSISTANT LICENSURE

Current through Register Vol. 39, No. 2, July 15, 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.