16
ABME Public Agenda January 16, 2019 1 SUPPLEMENTAL PUBLIC AGENDA ALABAMA STATE BOARD OF MEDICAL EXAMINERS JANUARY 16, 2019 I MINUTES PUBLIC MINUTES OF DECEMBER 12, 2018 II ENDORSEMENT Name Medical School Endorsement 1 Ali Said Al-Beshri King Faisal University, Dammam USMLE 2 Jennifer Lynne Anderson UASOM Birmingham USMLE 3 Kristine Emaline Andrade University of Southern California Keck SOM USMLE/CA 4 Olufolakemi Olaiya Awe Indiana University School of Medicine Indianapolis USMLE 5 * Alphonso Brenell Benton University of Southern California Keck SOM USMLE/CA 6 Gary Michael Bernard LSU Medical Center In Shreveport USMLE 7 Gary Leonard Bernstein Emory University School of Medicine NBME/GA 8 Bradley Michael Blappert Saba University School of Medicine USMLE/LA 9 Wilfredo Blasini Perez University of Puerto Rico School of Medicine USMLE/FL 10 Kyle David Bliton Medical College of Georgia School of Medicine USMLE 11 Sarah Beth Breaux LSU School of Medicine New Orleans USMLE 12 Elena Victoria Bryant Morehouse School Of Medicine USMLE 13 Andrew Carey Buie UASOM Birmingham USMLE 14 Joel Alan Butler Jr. University of Mississippi School of Medicine USMLE 15 Carter Louis Capra American University of The Caribbean USMLE/MS 16 * Matthew Stephen Carle UASOM Birmingham USMLE 17 Maurice Gerard Chen Saba University School of Medicine USMLE/OH 18 Jennifer Ming-Yee Chin Tulane University School of Medicine USMLE 19 Haley Routh Clark University of Mississippi School of Medicine USMLE/TX 20 Jonathan Patrick Coll Wright State University School of Medicine USMLE/OH 21 * John Orvil Collins U of Texas Southwestern Medical Center at Dallas FLEX/AR 22 Ryan Jonathan Cone Augusta University USMLE 23 Matthew Douglas Culling Ross University USMLE/MN 24 Michael Cullen Cunningham University of Mississippi School of Medicine USMLE/MS 25 Anjali Jaba Das Rutgers New Jersey Medical School USMLE 26 * Myrtle Ann Delgado Tulane University School of Medicine USMLE/LA 27 Noah DeLone FL International U Herbert Wertheim COM USMLE/NY 28 Christian Robert Deutsch Medical College of Georgia School of Medicine USMLE/KY 29 * Roy Adam Ferraiuolo University of Florida College of Medicine USMLE/FL

SUPPLEMENTAL PUBLIC AGENDA ALABAMA STATE BOARD OF …

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ABME Public Agenda January 16, 2019 1

SUPPLEMENTAL PUBLIC AGENDA ALABAMA STATE BOARD OF MEDICAL EXAMINERS

JANUARY 16, 2019

I MINUTES PUBLIC MINUTES OF DECEMBER 12, 2018 II ENDORSEMENT Name Medical School Endorsement

1 Ali Said Al-Beshri King Faisal University, Dammam USMLE

2 Jennifer Lynne Anderson UASOM Birmingham USMLE

3 Kristine Emaline Andrade University of Southern California Keck SOM USMLE/CA

4 Olufolakemi Olaiya Awe Indiana University School of Medicine Indianapolis USMLE

5 * Alphonso Brenell Benton University of Southern California Keck SOM USMLE/CA

6 Gary Michael Bernard LSU Medical Center In Shreveport USMLE

7 Gary Leonard Bernstein Emory University School of Medicine NBME/GA

8 Bradley Michael Blappert Saba University School of Medicine USMLE/LA

9 Wilfredo Blasini Perez University of Puerto Rico School of Medicine USMLE/FL

10 Kyle David Bliton Medical College of Georgia School of Medicine USMLE

11 Sarah Beth Breaux LSU School of Medicine New Orleans USMLE

12 Elena Victoria Bryant Morehouse School Of Medicine USMLE

13 Andrew Carey Buie UASOM Birmingham USMLE

14 Joel Alan Butler Jr. University of Mississippi School of Medicine USMLE

15 Carter Louis Capra American University of The Caribbean USMLE/MS

16 * Matthew Stephen Carle UASOM Birmingham USMLE

17 Maurice Gerard Chen Saba University School of Medicine USMLE/OH

18 Jennifer Ming-Yee Chin Tulane University School of Medicine USMLE

19 Haley Routh Clark University of Mississippi School of Medicine USMLE/TX

20 Jonathan Patrick Coll Wright State University School of Medicine USMLE/OH

21 * John Orvil Collins U of Texas Southwestern Medical Center at Dallas FLEX/AR

22 Ryan Jonathan Cone Augusta University USMLE

23 Matthew Douglas Culling Ross University USMLE/MN

24 Michael Cullen Cunningham University of Mississippi School of Medicine USMLE/MS

25 Anjali Jaba Das Rutgers New Jersey Medical School USMLE

26 * Myrtle Ann Delgado Tulane University School of Medicine USMLE/LA

27 Noah DeLone FL International U Herbert Wertheim COM USMLE/NY

28 Christian Robert Deutsch Medical College of Georgia School of Medicine USMLE/KY

29 * Roy Adam Ferraiuolo University of Florida College of Medicine USMLE/FL

ABME Public Agenda January 16, 2019 2

30 Ryan Anthony Frederiksen Saint Georges U Northeastern OH Univ COM USMLE/CA

31 Jose Nahun Galeas Soriano Universidad Nacional Autonoma De Honduras USMLE

32 Kyle Harrison Gennaro UASOM Birmingham USMLE

33 Aimee Soyun Paik German University of California San Diego SOM USMLE/CA

34 Zachary Aaron Glaser Vanderbilt University School of Medicine USMLE

35 Michael Lynn Gunter II University of South Alabama College of Medicine USMLE

36 John Patrick Guste LSU Medical Center In Shreveport USMLE/LA

37 Amr Habbach University of Damascus USMLE

38 Larissa Eileen Harkacz Tulane University School of Medicine USMLE

39 David Marshall Harris UASOM Birmingham USMLE

40 Jacob Kevin Hawkins Florida State University College of Medicine USMLE

41 Rodney Lemuel Holladay University of Tennessee Memphis COM FLEX/TN

42 Matthew Michael Hollie Medical College of Georgia School of Medicine USMLE

43 Robin Ifeoma Iriele Case Western Reserve University SOM USMLE

44 Adam Patrick Jacobs UASOM Birmingham USMLE

45 Joseph Arnell Jones UASOM Birmingham USMLE

46 Kenneth Wayne Jones Jr. Mercer University School of Medicine NBME/GA

47 Sehrish Kamal Dow Medical College, University of Karachi USMLE/MS

48 Joseph Taylor Klingen Texas Tech Univ School Of Medicine USMLE

49 Harshad Shrigopal Ladha Dr. Vaishampayan Memorial Medical College USMLE/AL

50 David Lee Boston University School of Medicine USMLE/MA

51 James Robert LePage Jr. Alabama College of Osteopathic Medicine COMLEX

52 Li Li Medical Center Of Fundan University USMLE/IA

53 Gabriel Eduardo Lugo Meharry Medical College School of Medicine USMLE

54 Justin Quoc Ly Uniformed Services University of Health Sciences USMLE/IN

55 Leonel F. Maldonado Gonzalez Ignacio A Santos Sch Med Inst Tech Higher St USMLE

56 Merry Lynn Mann UASOM Birmingham USMLE/TX

57 Anderson Scott Marshall TX A&M University Health Science Center COM USMLE

58 Nelson Felipe Matos Ruiz University of Puerto Rico School of Medicine USMLE/PR

59 Jessica Epperson McLemore UASOM Birmingham USMLE

60 Janet Marie McNaughton Florida State University College of Medicine USMLE/CA

61 Kent Michael Melchiors Indiana University School of Medicine Indianapolis USMLE

62 Gregory Alan Melish University of Texas Medical School at San Antonio USMLE/OK

63 Gabriel Joseph Menendez Augusta University USMLE

64 Gwen Ann Minzes Kansas City University of Medicine & Biosciences COMLEX

65 Grant Herron Moody Medical College of Georgia School of Medicine USMLE

66 Geoffrey Lyle Odom LSU School of Medicine New Orleans USMLE/LA

67 Olumide Temitope Omobo University of Virginia School of Medicine USMLE

68 Timothy Jay Orlowski Loyola University of Chicago Stritch SOM USMLE/FL

69 Jordan David Perchik University of Tennessee Memphis COM USMLE

70 Jacob Lawrence Pessia Ohio University College of Osteopathic Medicine COMLEX

71 Cody Allen Peterson UASOM Birmingham USMLE

72 John Taylor Pickens UASOM Birmingham USMLE

ABME Public Agenda January 16, 2019 3

73 Jedlyn Pierrilus University of Miami School of Medicine USMLE/MD

74 Max Rosenberg Pollock University of Arizona College of Medicine USMLE/CA

75 Samuel Glenn Porter University of Tennessee Memphis COM USMLE/GA

76 Jessica Tierce Powell UASOM Birmingham USMLE

77 John Michael Provenza LSU Medical Center In Shreveport USMLE

78 Shannon Leigh Reed Kirksville College of Osteopathic Medicine COMLEX/OK

79 Evan Kawika Reinhardt Touro U College of Osteopathic Medicine COMLEX/UT

80 Michael Nathaniel Rozenfeld Touro University College Of Osteopathic Medicine COMLEX/IL

81 Nathaniel Sbravati University of Mississippi School of Medicine USMLE

82 Rachel Suzanne Schare University of Louisville School of Medicine USMLE/FL

83 Manal Mosaad Schoellerman University of California, Irvine College of Medicine USMLE/CA

84 Kevin Thomas Schwalbach Univ of Minnesota Medical School - Minneapolis USMLE

85 Jason Gregory Smith Vanderbilt University School of Medicine USMLE/TX

86 Trevor Dylan Smith University of Arkansas College of Medicine USMLE

87 William Benjamin Smith West Virginia School of Osteopathic Medicine COMLEX/NE

88 Blaire Marie Williams Smith West Virginia School of Osteopathic Medicine COMLEX

89 Austin Chandler Starnes UASOM Birmingham USMLE

90 Luke Mitchell Stewart Brody SOM at East Carolina University USMLE

91 Scott Michael Strickler E TN State University James H Quillen COM USMLE

92 Shane Fancher Strom LSU Medical Center In Shreveport USMLE

93 * Eugene Frank Tareshawty Jr. Universidad Central Del Este (UCE) FLEX/OH

94 William Blake Tennant USACOM USMLE

95 James Michael Terzian SUNY Upstate Medical University COM USMLE/NY

96 Sirsha Reddy Thambuluru University of Central Florida College of Medicine USMLE

97 William Jacob Thomas University of South Alabama College of Medicine USMLE

98 * Saraswathi Bai Tirumalasetty Guntur Medical College, Nagarjuna University FLEX/FL

99 Anson Varghese Touro University College Of Osteopathic Medicine COMLEX

100 Sanjeevi Vridhachalam New York Medical College USMLE/CA

101 Justin Todd Watts University of Mississippi School of Medicine USMLE

102 Lucinda Weaver University of South Dakota SOM Vermillion USMLE

103 Kristopher Ross Weemes Michigan State Univ College Of Osteo Medicine COMLEX/MI

104 Margaret Compton Yates UASOM Birmingham USMLE

105 Mazen Zaarour Lebanese University USMLE/LA

SPECIAL PURPOSE LICENSE Scanned with Endorsements Name Location Type of Practice

1 Paresh Arora Avon Lake, OH Teleradiology

2 Olena Dorokhova Brentwood, TN Teledermatopathology

ABME Public Agenda January 16, 2019 4

II LIMITED LICENSE Name Medical School Endorsement

1 * Zakeya M. Al-Sadah King Faisal University, Dammam LL/AL

2 Stephanie Bustros American University of Beirut LL/AL

3 Yesica Andrea Campos Universidad Militar Nueva Granada LL/AL

4 Swetha Srialluri Konaseema Inst of Med Sci and Res LL/AL

IV PHYSICIAN ASSISTANTS / ADVANCED PRACTICE NURSES (11) Cover Sheet P.A. License Name School NCCPA

1 Jessica Lyons-Farino, PA D’Youville College 1082376 2 Samantha Hawley, PA Massachusetts Col of Pharm and Hlth Sci 1144767 3 Roxzy Mabry, PA Nova Southeastern University 1123469 4 Meredith Veazey, PA UAB 1131663 5 Camille Dixon, PA Midwestern University 1108102 6 Kathryn Kings, PA Nova Southeastern University 1155473

A.A. License Name School NCCAA No AA License Applicants Temporary P.A. License Name School NCCPA

1 Madeline Hargis UAB Pending PANCE Results

2 Tabitha Abernathy, PA UAB Pending PANCE Results

3 Chelsi Davis, PA UAB Pending PANCE Results

4 Taylor Davis, PA UAB Pending PANCE Results

5 Cassidy Dickson, PA UAB Pending PANCE Results

6 Alayna Holderfield, PA UAB Pending PANCE Results

7 Tyler Jones, PA UAB Pending PANCE Results

8 Morgan Lee, PA UAB Pending PANCE Results

ABME Public Agenda January 16, 2019 5

9 Jessica Mena, PA UAB Pending PANCE Results

10 Charles Preston, PA UAB Pending PANCE Results

11 Jenna Risley, PA UAB Pending PANCE Results

12 Andrea Rowe, PA UAB Pending PANCE Results

13 Lindsay Simmons, PA UAB Pending PANCE Results

Temporary P.A. License to Full License Name School NCCPA No Temporary PA License to Full License Applicants P.A. Registration Without additional duties; With Qualified Remote Sites; Formulary: #2, #21, #23

PA / Physician Registration / Remote Site / Formulary Recommendation

1 Elizabeth Eisenbeis, PA Nicole Kersh, M.D.

Registration Birth Control Drugs and Devices

2 Lacey Bowen, PA Grady Maddox, M.D.

Registration

3 Samantha Hawley, PA Julie Gladsjo, M.D.

Registration

4 Andrea Jost, PA Jeffrey Jones, M.D.

Registration Birth Control Drugs and Devices

5 Roxzy Mabry, PA Camy Beall, M.D.

Registration

6 Emily Mullady, PA Michael Blum, M.D.

Registration

7 Rachel Ragland, PA Dewey Jones, M.D.

Registration

8 Leigh Smalley, PA Timothy Ricketts, M.D.

Registration

9 Haley Basford, PA Kathleen Shine, M.D.

Registration

10 Adam Bevis, PA Aftab Khan, M.D.

Registration Remote site Birth Control Drugs and Devices

11 Judith Blake, PA Grant Stone, D.O.

Registration

12 Cassidy Dickson, PA Conrad De Los Santos, D.O.

Registration

13 Camille Dixon, PA David Lortscher, M.D.

Registration

ABME Public Agenda January 16, 2019 6

PA / Physician Registration / Remote Site / Formulary Recommendation

14 Ann Elliott, PA James Cavender, M.D.

Registration

15 Latrinia Franklin, PA Joseph Schultz, M.D.

Registration Antineoplastic Agents Birth Control Drugs and Devices

16 Ivey Holt, PA Lance Westerlund, M.D.

Registration Birth Control Drugs and Devices

17 Tyler Jones, PA Patrick Lett, M.D.

Registration

18 Shanna Killebrew, PA John Burgess, M.D.

Registration

19 Jessica Mena, PA Brian Tierney, M.D.

Registration

20 Diana O’Reilly, PA Mathias Allen, M.D.

Registration Birth Control Drugs and Devices

21 Charles Preston, PA Cheng Tao, M.D.

Registration Remote site

22 Jenna Risley, PA Jared Cox, M.D.

Registration

23 Andrea Rowe, PA Timothy Frerichs, M.D.

Registration

With additional duties; Remote site; Misc. Formulary requests

PA / Physician Registration / Remote Site / Formulary Recommendation

1 (15)

Theresa Rehm-Hamilton, PA Mark Haygood, M.D.

Registration Remote Site Formulary: Antidepressants, Non-Benzodiazepine anxiolytics, Antipsychotics, Mood Stabilizers, Anticonvulsants, Cognitive Enhancers,Non-Stimulant ADHD Medications, Opioid Antagonists, Alcohol Dependence Medications, Alpha Blockers, Anticholinergics, V-mat 2 Inhibitors, Antiemetics, Melatonin Receptor Agonists

2 (30)

Lori Tippets, PA Duane Tippets, D.O.

Registration Approval to train: Arthrocentesis; Injections of the Shoulder; Injections of the Elbow (Olecranon Bursa); Injections of the Knee, Injections of the Greater Trochanteric Bursa Standard Language is available

ABME Public Agenda January 16, 2019 7

PA / Physician Registration / Remote Site / Formulary Recommendation

3 (44)

Amanda Ward, PA Carole Lane, M.D.

Registration Formulary: Antineoplastic Agents, Birth Control Drugs and Devices, Enbrel, Stelara, Humira, Cosentyx, Taltz, Apremilast, CellCept, and Cyclosporine Approval to Train: Shave and Punch Biopsy Standard Language is available

A.A. Registration 1. Joseph Bodin, III, AA / James Bridges, D.O. P.A. / A.A. Miscellaneous Requests / Reports Within Protocol

PA / Physician Request Recommendation

1 (61)

Derok Cornwell, PA James Smith, M.D.

Approve Supervise Practice: Arthrocentesis and Joint Injections

2 (69)

Megan Harris, PA Ryan Ramagosa, M.D.

Additional Practice Site Location: Sunrise Dermatology 8832 US Highway 90 Daphne, AL 36526

3 (71)

Katherine Ivey, PA Billy McGough, M.D.

Approval to Train: Arthrocentesis and Joint Injections Standard Language is available

Strike from agenda

4 (75)

Michael Pugh, PA Erik Hernandez, M.D.

Approve Supervise Practice: Central Venous Line- Femoral

5 (83)

Allen Veren, PA Robert Sorell, M.D.

Approval to Train: Arthrocentesis and Joint Injections Standard Language is available

Strike from agenda

6 (86)

Sarah Welch, PA Michael Ledet, M.D.

Additional Practice Site Location: Hope Center 10274 St Hwy 104 Fairhope, AL 36532

7 (SA)

Judith Blake, PA Grant Stone, D.O.

Approval to Train: Arthrocentesis; Joint Injections (Shoulder, Knee, and Greater Trochanteric Bursa), and Trigger Point Injections Standard Language is available

8 (SA)

Chris Boyce, PA David Pigott, M.D.

Additional Practice Site Location: UAB Medicine Gardendale 210 Fieldstown Road Gardendale, AL 35071

ABME Public Agenda January 16, 2019 8

Outside Protocol

PA / Physician Request Recommendation

1 (90)

Kelly Fordham, PA Jenny Sobera, M.D.

Formulary: Antineoplastic Agents, Birth Control Drugs and Devices, Isotretinoin, Biologic Agents (Psoriasis) Approval to Train: Photodynamic Therapy; Laser (Hair Removal, KTP); IPL; Radiofrequency procedures; *Cryotherapy; Electrodessication; *Skin Biopsies (Punch and Shave); Curettage; Removal/Destruction of Cutaneous Lesions; *Sclerotherapy; and Intralesional Injections *Standard Language is available

2 (100)

Lily Nizam, PA Sami Nizam II, M.D.

Request to train: Soft Tissue and Dermal Hyaluronic Acid Filler Administration; *Chemical Peel; Poly-L-Lactic Acid (PLLA) Administration; Neurotoxin Administration; Non-Ablative Lasers *Standard Language is available

3 (124)

David Gilmore, PA Lauren Tucker, PA Doyle Wingate, PA Ahmed Kamel, M.D.

Request to train: Tunneled Central Venous Catheter Placement Request does not align with existing Standard Language

P.A. QACSC Registration

PA PHYSICIAN

1 Lindsey Mangum, PA Rodney Soto, M.D. 2 Nicolaus Ruehl, PA Frank Francone, M.D. 3 Lauren Smith, PA James Wilhite, M.D. 4 Suzanne Tompkins, PA Michael DiChiara, M.D. 5 Carly Garvey, PA Matthew Bennett, M.D.

P.A. Limited Purpose Special Permit

PA / Physician Request Recommendation Approve Deny

1 (131)

Edward Daugherty, D.O. Adam Bevis, PA Specialty: Family Medicine/Emergency Medicine

ADHD Medications Hydrocodone Combinations Hydrocodone (Cough Preparations) Oxycodone-Immediate Release

ABME Public Agenda January 16, 2019 9

Collaborative Practice / APN QACSC Registration (SA) Collaborative Practice Registration (SA) Collaborative Practice Modification (SA) Collaborative Practice Covering Physician Applicants (SA) Limited Protocol Applicants (SA) CRNP / CNM QACSC Registration Applicants APN Miscellaneous Requests / Reports (133) Cover Sheet Skills Requests Within Protocol

Physician /NP Request Recommendation

1 (135)

Michael Christopher Allemand, M.D. Megan S. Bush, CRNP

Approval of supervised practice: Sonar Insufflation Studies (10)

2 (139)

Scott C. Bellot, M.D. Cathy Willis, CRNP

Approval of supervised practice: Removal of pacing wires(30); Swan Ganz catheter(30); IABP catheter (13); mediastinal chest tube (17)

3 (153)

James Stuart Early Booth, M.D. Somali H. Nguyen, CRNP

Train to perform skills included in the Orthopedic Specialty Protocol: Arthrocentesis; Joint injection of shoulder, elbow(olecranon bursa) and knee

4 (163)

Kenneth W. Bramlett, M.D. Christopher C. Berry, CRNP

Approval of supervised practice: joint injections of shoulder (10); elbow (olecranon bursa) (3); greater trochanteric bursa (7) and knee (14).

5 (173)

Christopher O. Harper, M.D. Elizabeth H. Yarbrough, CRNP

Transfer approval of skills included in Orthopedic Specialty Protocol

6 (183)

Clinton Howard IV, M.D. Adam R. Smith, CRNP

Approval of supervised practice: joint injections of the shoulder (6); greater trochanteric bursa (13); and knee (6).

7 (187)

Daniel A. Kelmenson, M.D. Chad W. Lynch, CRNP

Train to perform skills included in Critical Care Specialty Protocol: central venous line insertion, internal jugular and femoral; arterial line insertion, femoral

ABME Public Agenda January 16, 2019 10

Physician /NP Request Recommendation

8 (196)

David Mauchley, M.D. Christopher Ford, CRNP

Transfer approval of Critical Care Specialty Protocol and previously approved supervised practice for removal of pacing wires

9 (205)

David W. Miller, M.D. Julia I. Rohwedder, CRNP

Train to perform skills included in the Critical Care Specialty Protocol: central venous line insertion, internal jugular

10 (211)

Philip O`Reilly, M.D. Kirsten E. Strawn, CRNP

Train to perform skills included in Critical Care Specialty Protocol: central venous line insertion, internal jugular and femoral; arterial line insertion, femoral

11 (219)

Philip O`Reilly, M.D. Amanda K. Varley, CRNP

Train to perform skills included in Critical Care Specialty Protocol: central venous line insertion, internal jugular and femoral; arterial line insertion, femoral

12 (228)

Rishi Raj Rajan, M.D. David G. Farr, CRNP

Percutaneous Tibial Nerve Stimulation

13 (233)

Eric Paul Robinson, M.D. Andrew T. Eden, CRNP

Train to perform Trigger point injections below T-12

14 (236)

Christopher W. Roney, M.D. Teresa R. Cooper, CRNP

Train to perform skills included in Critical Care Specialty Protocol: central venous line insertion, internal jugular and femoral

15 (242)

Janyce Sanford, M.D. Jonathan D. Borella, CRNP

Train to perform skills included in Orthopedic Specialty Protocol: Arthrocentesis

16 (252)

James Patrick Siler, M.D. Valerie Jane Vargas, CRNP

Train to perform skills included in Orthopedic Specialty Protocol: arthrocentesis, elbow (olecranon bursa), shoulder, knee

Skills Requests Outside Protocol

Physician /NP Request Recommendation

1 (262)

Scott Bellot, M.D. Amy Johnson, CRNP

Approval of supervised practice outside one year for: Removal of pacing wires(39); Swan Ganz catheters (30); Pleural catheters (34); Mediastinal chest tubes (44)

2 (285)

Christopher O. Harper, M.D. Ashley C. Scoggins, CRNP

Transfer approval of skills included in Orthopedic Specialty Protocol Train to perform Trigger Point Injections below T-12

3 (297)

William L. Holman, M.D. Margaret Weaver, CRNP

Approval of supervised practice outside one year for: Removal of pacing wires (31); Swan Ganz catheters (30); IABP catheters (10); mediastinal chest tubes (15)

ABME Public Agenda January 16, 2019 11

Physician /NP Request Recommendation

4 (303)

David Mauchley, M.D. Jessica Cha, CRNP

Approval of supervised practice outside one year for: Removal of pacing wires (34); Swan Ganze catheter (41); IABP catheter (17); pleural catheter (8) and mediastinal chest tubes (40).

5 (318)

David Mauchley, M.D. Justin Wright, CRNP

Approval of supervised practice outside one year for: Removal of pacing wires (43); Swan Ganz catheters (45); IABP catheter (24); Pleural catheters (21); mediastinal chest tubes (40).

6 (326)

Collaborative Practice FTE Limits/ Standard Protocol Management

Proposal for Rule Change to increase FTE limits Slide presentation for management of standard protocol

APN Limited Purpose Special Permit (360) Cover Sheet

Physician/ Specialty/ Current Clinical Practice, CRNP/ Specialty/ Current Practice:

LPSP Formulary Request:

Recommendation Approve Deny

1 (367)

Mohammad Aryanpure, M.D. Family Medicine Primary Care Clinic Kimberly Flowers, CRNP FNP

ADHD Medications Hydrocodone SA Hydrocodone Cough Preps Oxycodone IR

2 (368)

Muhammed Ata, M.D. Internal Medicine Primary Care Clinic Rachelle Key, CRNP FNP

ADHD Medications Hydrocodone SA Hydrocodone Cough Preps MSIR Oxycodone IR

3 (369)

Renita Brown, M.D. Internal Medicine Private Practice Optum Health/ home visits and hospice Robin Scott, CRNP FNP

ADHD Medications Hydrocodone SA Hydrocodone Cough Preps MSIR Oxycodone IR Fentanyl LA Hydrocodone LA Hydromorphone Morphine LA

4 (371)

Carlos Clark II, M.D. Family Medicine Primary Care Clinic

Hydrocodone SA MSIR Oxycodone IR

ABME Public Agenda January 16, 2019 12

Physician/ Specialty/ Current Clinical Practice, CRNP/ Specialty/ Current Practice:

LPSP Formulary Request:

Recommendation Approve Deny

Nursing homes; Rehab Centers; Assisted Living Centers Shawna Mason, CRNP FNP

Fentanyl LA Hydrocodone LA Morphine LA Oxycodone LA

5 (373)

Ryan Cordry, D.O. Orthopaedic Surgeon Orthopaedic Clinic Breanne Connors, CRNP Adult-Gerontological Acute Care NP

Hydrocodone SA Hydrocodone Cough Preparations Oxycodone IR Hydromorphone Tapentadol ER

6 (375)

Darla Cowart, M.D. Family Medicine Total Sports Care University Clinic Connie Abbott, CRNP FNP

Hydrocodone SA Hydrocodone Cough Preps Oxycodone IR

7 (376)

Jonathan Dean, M.D. Family Medicine Rural Health Clinic Valerie Berry, CRNP FNP

ADHD Medications Hydrocodone SA Hydrocodone Cough Preps Oxycodone IR Fentanyl LA Hydrocodone LA Morphine LA Oxycodone LA

8 (378)

Robert Eaton, D.O. Family Medicine Primary Care Clinic Heather Farris, CRNP FNP

ADHD Medications Hydrocodone SA Hydrocodone Cough Preparations Oxycodone IR

9 (379)

Milton George, D.O. Family Medicine Primary Care Clinic Brandi Ray, CRNP Adult-Gerontological Acute Care NP

ADHD Medications Hydrocodone SA Hydrocodone Cough Preparations Oxycodone IR

ABME Public Agenda January 16, 2019 13

Physician/ Specialty/ Current Clinical Practice, CRNP/ Specialty/ Current Practice:

LPSP Formulary Request:

Recommendation Approve Deny

10 (380)

Rommel Go, M.D. Internal Medicine Rural Health Clinic Jennifer Giddens, CRNP FNP

ADHD Medications Hydrocodone SA Hydrocodone Cough Preparations MSIR Oxycodone IR Tapentadol SA Fentanyl LA Hydrocodone LA Morphine LA Oxycodone LA Tapentadol, Extended-release

11 (382)

Richard Grant, M.D. Psychiatry Pain Practice (PM Registration 673) Toni Hosea, CRNP FNP

Hydrocodone SA MSIR Oxycodone IR Tapentadol SA

12 (383)

Herbert Holdsambeck, M.D. Family Medicine Private Clinic University Clinic Amber McPhail, CRNP FNP

Hydrocodone SA Hydrocodone Cough Preparations Oxycodone IR

13 (384)

Aaron Karr, D.O. Family Medicine Primary Care; Home Health; Hospice Melody Smith, CRNP Adult NP

ADHD Medications Hydrocodone SA Hydrocodone Cough Preparations MSIR Oxycodone IR Tapentadol SA

14 (385)

Moh’d Khushman, M.D. Medical Oncologist Oncology Clinics and Hospital Vanessa Jones, CRNP Adult NP

Hydrocodone SA Hydrocodone Cough Preparations MSIR Oxycodone IR Fentanyl LA Hydrocodone LA Hydromorphone Morphine LA Oxycodone LA

ABME Public Agenda January 16, 2019 14

Physician/ Specialty/ Current Clinical Practice, CRNP/ Specialty/ Current Practice:

LPSP Formulary Request:

Recommendation Approve Deny

15 (387)

Vincent Law, M.D. Family Medicine Primary Care Clinic Jamie Chappell, CRNP FNP

ADHD Medications Hydrocodone SA Hydrocodone Cough Preparations MSIR Oxycodone IR

16 (388)

Tonya Lyles, M.D. Pediatrician Pediatric Clinic Kristie Johnson, CRNP FNP

ADHD Medication

17 (389)

Bryan McClelland, M.D. Family Medicine Geriatric Medicine Primary Care Clinic Jennifer Gafnea, CRNP FNP

ADHD Medications Hydrocodone SA Hydrocodone Cough Preparations MSIR Oxycodone IR Fentanyl Hydromorphone

18 (391)

Ashley McCloud, M.D. OB/GYN OB/GYN Clinic Shequita Madry, CRNP Women’s Health Care NP

Hydrocodone SA Oxycodone IR

19 (392)

Ashley McCloud, M.D. OB/GYN OB/GYN Clinic Kristine Putman, CRNP FNP

Hydrocodone SA Oxycodone IR

20 (393)

Howard McVeigh, M.D. Emergency Medicine Urgent Care Hala Mourtada, CRNP FNP

ADHD Medications Hydrocodone SA Hydrocodone Cough Preparations Oxycodone IR

21 (394)

Norma Mobley, M.D. Pediatrician Pediatric Clinic LaTanya Bryant, CRNP FNP

ADHD Medication

22 (395)

Randall Murphy Jr, M.D. Orthopaedic Surgeon Orthopaedic Clinic Nathan Evans, CRNP FNP

Hydrocodone SA Oxycodone IR Tapentadol SA Hydromorphone Oxycodone LA Oxymorphone

ABME Public Agenda January 16, 2019 15

Physician/ Specialty/ Current Clinical Practice, CRNP/ Specialty/ Current Practice:

LPSP Formulary Request:

Recommendation Approve Deny

23 (397)

Samantha Ross, M.D. Family Medicine Primary Care Clinic Karen Thompson, CRNP FNP

Hydrocodone SA Hydrocodone Cough Preparations

24 (398)

Bradley Sadler, M.D. Psychiatrist Psychiatry Clinic Crystal Threadgill, CRNP Family Psychiatric and Mental Health NP

ADHD Medication

25 (400)

Amanda Smith, M.D. Family Medicine Urgent Care David Hurley, CRNP FNP

Hydrocodone SA Hydrocodone Cough Preparations

26 (401)

Shelly Weisenfeld, M.D. Family Medicine Primary Care Clinic Ramona Roach-Davis, CRNP FNP

ADHD Medications Hydrocodone SA Hydrocodone Cough Preparations

27 (402)

Andrew Wilkerson, M.D. Psychiatrist Neuropsychiatry Clinic and hospital Larry Sneed, CRNP Family Psychiatric and Mental Health NP

ADHD Medications Hydrocodone SA Hydrocodone Cough Preparations MSIR Oxycodone IR Tapentadol SA Fentanyl LA Hydrocodone LA Hydromorphone Morphine LA Oxycodone LA Oxymorphone Tapentadol ER

28 (404)

Duane Williams, M.D. Pediatrician Pediatric Clinic Melinda Gibson, CRNP Pediatric NP

ADHD Medications Hydrocodone SA Hydrocodone Cough Preps

29 (405)

Salah Al-Abbadi, M.D. Family Medicine Rural Health Clinic; Nursing Home; Hospice Mary Huckabee, CRNP FNP

Requesting to expand existing LPSP #918-16159 to include the following: Morphine IR Morphine LA

ABME Public Agenda January 16, 2019 16

Physician/ Specialty/ Current Clinical Practice, CRNP/ Specialty/ Current Practice:

LPSP Formulary Request:

Recommendation Approve Deny

30 (409)

William Spiegel, M.D. Internal Medicine Hospice and Palliative Care Dennis Doss, CRNP Adult-Gerontological Primary Care NP

Requesting to reconsider to expand LPSP #521-11858 to add Methadone for treating pain for Hospice and Palliative Care patients (see letter signed by Dr William Spiegel and colleagues)

Joint Committee for Advanced Practice Nursing Joint Committee for Advanced Practice Nursing Meeting – January 15, 2019, 6:00 p.m. CURRENT BUSINESS (2) 1. FSMB: U.S. Medical Regulatory Trends and Actions (SA) 2. HHS Draft Report on Pain Management Best Practices PERSONNEL No Personnel Items VI HEARINGS (2) ABME Hearing Schedule No Hearings scheduled for January EXECUTIVE SESSION