P.A. Application

You may access the online application for license as a Physician Assistant by using the Continue button at the bottom of the page.

As part of completing your online application, you will need to upload the following documents:

1. Name Change:
   • Upload documentation of Name Change (e.g. marriage certificate or divorce document).
     • Note: If your name has changed, and any of your licensure documentation shows a different name, you will need to provide documentation of this change (e.g. marriage certificate or divorce document).
2. Color Photo:
   • Upload a recent (within 60 days) passport quality color Photograph.
3. Application Fee:
   • Submit a $100.00 Application Fee and 2.25% processing fee. This is paid only once, either by the Supervising Physician, the Physician Assistant, or the company for whom you will be working.
4. Practice Notification Fee:
   • If applying for a license and a Practice Notification, submit a $200.00 Application Fee and 2.25% processing fee for both documents.

After submitting your online application, you will need to have the following items sent to the board office:

1. National Certification Certificate:
   • Mail or upload a copy of your original National Certification certificate from NCCPA, as well as a copy of your current renewal certification. Current NCCPA Certification is not required if you are currently licensed in good standing in a state that does not require that certification be maintained.
2. Official Transcript:
   • Arrange for an Official Transcript to be sent directly to the Board office from the School where you attended the Physician Assistant Program.
3. Certification of Physician Assistant Program:
   • Download a Certification of Physician Assistant Program form. Forward the form to the Physician Assistant Program you attended for them to complete and return to our office.
4. National Practitioner Data Bank Self-Query:
   • Generate and submit an NPDB self-query. Your report must have been generated within thirty days of the date you provide it to the Board. Instructions for Self-Query requests are located at https://www.npdb.hrsa.gov/ext/selfquery/SQHome.jsp.
     You may forward a pdf of the self-query report to cammie.j.mcclure@wv.gov. or you may provide the original paper copy you receive via US mail.
5. Criminal Background Check:
   • Obtain a Criminal Background Check.  Present to one of the 31 IdentoGO Centers in West Virginia www.identogo.com or MorphoTrust in South Charleston, West Virginia.  Advise them the reports are to be sent to WV Board of Osteopathic Medicine.  The cost will be $44.50.
     • State and Federal reports are required.
     • You will need the Service Code: 228QBF in order to process the fingerprints.

If you have any questions, please contact our office.