Application Request

To begin the process of requesting privileges or adding privileges for any Novant Health facility, please submit an application request. Medical staff and advanced practice providers (APPs) can read Novant Health board certification requirements in the next tab.

Please note that the asterisks denote mandatory fields, which must be completed before the Credentialing and Medical Staff Operations (CMSO) team can begin processing your request.

Qualifications checklist

Prospective applicants for membership and/or clinical privileges must:

  • have a current and unrestricted license to practice in North Carolina or Virginia, or an application for a license in process, in a discipline eligible for membership; 
  • are board-eligible or board-certified;
  • have current and valid professional liability insurance coverage, or an application for coverage in process, from an insurance company that is licensed or approved to do business in North Carolina or Virginia;
  • be eligible to participate in Medicare, Medicaid and other federally funded healthcare programs and not be excluded, suspended, debarred or otherwise declared ineligible to participate in a federally funded healthcare program;
  • have a current, valid and unrestricted DEA registration, or have an application for a DEA registration in process, as required;
  • have not had clinical privileges terminated from a Novant Health hospital or from two or more non-Novant Health health systems or healthcare facilities; and
  • have a primary supervising physician who is currently on staff in good standing, or be simultaneously applying for membership and clinical privileges as a category 2 advanced practice provider.
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Board certification must be achieved within the timeframe set by the specialty board to within five years of completing residency or fellowships training, whichever is earlier. When recertification is required, recertification must be obtained within two years.

Medical Staff Members

  • Physicians: MD applicants must be board certified or board eligible in their primary specialty or subspecialty by an American Board of Medical Specialties (ABMS) member board. DO applicants must be board certified or board eligible in their primary specialty or subspecialty by the American Osteopathic Association (AOA).
  • Oral surgeons who are not physicians: DDS and DMD applicants who are oral surgeons but not physicians must be board certified or board eligible by the American Board of Oral and Maxillofacial Surgery (ABOMS).
  • Podiatrics:  DPM applicants must be board certified or board eligible by the American Board of Podiatrics Medicine or the American Board of Foot and Ankle Surgery

Advanced Practice Providers:

Advanced Applicant Provider (APP) applicants for clinical privileges must be certified by the appropriate board and meet any recertification requirements, as follows:

  • Certified nurse midwife must be certified by the American Midwifery Certification Board;
  • Certified registered nurse anesthetists must be certifies by the National Board of Certification and Recertification for Nurse Anesthetists;
  • Chiropractors must be certified by the National Board of Chiropractic Examination;
  • Nurse practitioners must be certified by the American Nurses' Credentialing Center, American Academy of Nurse Practitioners, American Association on Critical Care Nurses, National Certification Corporation or the Pediatric Nursing Certification Board;
  • Optometrists must be certified by the National Board of Examiners in Optometry;
  • Physician assistants must be certified by the National Commission on the Certification of Physician Assistants.
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