West Virginia Code of State Rules › Agency 11 - Medicine › Title 11 - LEGISLATIVE RULE WEST VIRGINIA BOARD OF MEDICINE › Series 11-01B - Licensure, Practice Requirements, Disciplinary and Complaint Procedures, Continuing Education, Physician Assistants › Section 11-1B-3 - Qualification and Application for Licensure to Practice as a Physician Assistant

Current through Register Vol. XLI, No. 28, July 12, 2024
3.1. Minimum
				qualifications for licensure as a physician assistant are set forth in W. Va.
				Code §
									30-3E-4.
3.2. An application for a license to practice
				as a physician assistant shall be completed on a form provided by the Board,
				which is available on the Board's website. The Board shall not consider an
				application or decide upon the issuance of a license to an applicant until the
				complete application, including all third-party documentation or verification,
				is on file with the Board and the Board has had at least 15 days to review the
				application. An application for licensure must be accompanied by payment of a
				nonrefundable application fee in an amount established by 11 CSR 4 unless the
				applicant has applied for and been granted an initial licensing fee waiver as
				set forth in 11 CSR 13.
3.3.
				Applicants must provide the following information:
3.3.1. The applicant's name, email address,
				home address, preferred mailing address and primary practice location
				address(es) and telephone numbers;
3.3.2. Demographic information of the
				applicant, such as date of birth, sex, etc.;
3.3.3. A photograph taken within the previous
				12 months which substantially resembles the applicant;
3.3.4. A copy of the individual's birth
				certificate, certificate of naturalization, or passport to be used in
				identifying the applicant, and verifying his or her date of birth and the
				appropriate spelling of his or her name;
3.3.5. Documentation establishing that the
				applicant:
3.3.5.a. Obtained a baccalaureate
				or master's degree from an accredited program of instruction for physician
				assistants; or
3.3.5.b. Graduated
				from an approved program of instruction in primary health care or surgery prior
				to July 1, 1994; or
3.3.5.c. Was
				certified by the Board as a "Type B" physician assistant prior to July 1,
				1983;
3.3.6.
				Documentation that the applicant has passed the Physician Assistant National
				Certifying Examination administered by the NCCPA and documentation establishing
				that the applicant:
3.3.6.a. Has a current
				certification from the NCCPA; or
3.3.6.b. Has a current license in good
				standing from a state that does not require a physician assistant to maintain
				national certification;
3.3.7. A report from the National
				Practitioner Data Bank and documentation and/or certification which establishes
				that the applicant does not hold a physician assistant license, certification
				or registration in any jurisdiction which is currently suspended or
				revoked;
3.3.8. Information with
				respect to the applicant's professional practice, character and fitness to
				practice as a physician assistant;
3.3.9. Other information as determined by the
				Board which relates to whether the applicant is mentally and physically able to
				engage safely in practice as a physician assistant; and
3.3.10. Additional information identified by
				the Board for licensure.