APPENDIX A
CATEGORY I AND CATEGORY II PRACTITIONERS ELIGIBLE FOR APPOINTMENT TO ADVANCED PRACTICE PROVIDER STAFF
Category I APPs : Licensed Independent Practitioners shall consist of the following types of providers : ( a ) May be granted independent practice as the primary attending service :
1 . Certified Nurse Midwife ( with backup by sponsoring physician / group )
( b ) May be granted independent practice as part of a consulting service , i . e . patient ’ s care is otherwise overseen by a physician from another service : 1 . Clinical Nurse Specialist ; 2 . Nurse Practitioner , Palliative Care 3 . Nurse Practitioner , Wound Care , 4 . Psychologist / Neuropsychologist , 5 . Cardiovascular Perfusionist , and 6 . Registered Dietician
( c ) May be granted independent practice as part of a Hospital Outpatient Department ( HOD ) 1 . Nurse Practitioner ( NP ), including Family NP ( FNP ), Psychiatric Mental Health NP
( PMHNP ), 2 . Psychologist / Neuropsychologist
Category II APPs : Licensed Advanced Dependent Practitioners shall consist of the following types of APPs : ( requires Supervising Physician ) 1 . Anesthesiologist Assistant ; 2 . Certified Registered Nurse Anesthetist ; 3 . Physician Assistant ; and 4 . Nurse Practitioner in admitting / consulting medicine / surgical specialties , i . e ., Hospitalist , Critical Care , Gastroenterology , Cardiology , Neurosurgery , Surgery , Surgical Subspecialties , Medical Subspecialties .
5 . Neurodiagnostic Intraoperative Monitoring Technician ;
Category III Practitioners : Dependent Practitioners ( requires Supervising Physician ) for which
Credentialing & Privileging Manual applies . 1 . Non-Physician Surgical First Assist ( Non-physician , Non-PA , Non-APRN ) 2 . Dental Assistant 3 . Ophthalmic Assistant
Category I Practitioners must have a sponsoring physician with appropriate privileges who provides oversight of appointment , care , treatment and services . The sponsoring physician must be willing to support his / her involvement in Patient / Service Encounters during the individual ’ s initial appointment term , but a sponsoring physician is not required for reappointment .
4877-0873-6192 , v . 3