SUPPLEMENTAL PUBLIC AGENDA ALABAMA BOARD OF MEDICAL EXAMINERS September 17, :00 a.m. Name Medical School Endorsement

SUPPLEMENTAL PUBLIC AGENDA ALABAMA BOARD OF MEDICAL EXAMINERS September 17, 2014 10:00 a.m. I PUBLIC MINUTES OF AUGUST 20, 2014 II ENDORSEMENT Name ...
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SUPPLEMENTAL PUBLIC AGENDA ALABAMA BOARD OF MEDICAL EXAMINERS September 17, 2014 10:00 a.m. I

PUBLIC MINUTES OF AUGUST 20, 2014

II ENDORSEMENT Name 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31

Medical School

Endorsement

* John Henry Agnone Tulane University School of Medicine FLEX/LA Melinda Lydia Alba University of Illinois College of Medicine Chicago USMLE/IL Kristin Kate Andreen Michigan State Univ College of Human Medicine USMLE/CO * Nathan Howard Beasley Mercer University School of Medicine USMLE * David Kevin Beato Saint Louis University School of Medicine NBME/MO * Sameer Bellapravalu Kakatiya Medical College Osmania University USMLE/WV * Stephanie Margaret Bien Univ of New England College of Osteo Medicine NBOME/FL Edward Slocum Brewer Boston University School of Medicine USMLE/VA Wilma Kristine Briones Mull Medical University of the Americas (Nevis) USMLE/GA Benjamin Robert Broome Medical College of Georgia School of Medicine USMLE/TN Frank Burton University of Padua NBME/FL Sana Ehsan Sindh Medical College University of Karachi USMLE/KY Johannes Daniel Engelbrecht University of Pretoria USMLE Rebecca Ann Gooch State Univ of New York Upstate Medical Univ USMLE/NY Matthew David Hanserd USACOM USMLE/TN * Seth Adam Jarrell UASOM Birmingham USMLE/AL * Vladimir Karpitskiy Krymskij Medical Institute USMLE/AR * Cindy Marie McCord Saint Georges University USMLE/SC Lisa Michelle Minge Creighton University School of Medicine USMLE/WY Naresh Nekkanti Zaporozhye State Medical University USMLE/IL * Kevin Francis O'Meara University of Nebraska College of Medicine FLEX/UT * Vaibhav Vinubhai Patel University of Ibadan FLEX/NJ Timothy Michael Peters UASOM Birmingham USMLE * Donald Barrymore Alexander Plummer Saint Georges University USMLE/FL Mark Lawrence Rynda Des Moines University of Osteo Medical Center COMLEX * Zvika Jacob Schreiber Medical College of Wisconsin USMLE/NY Western U of Hlth Sci Col of Osteo Med of Pacific Viplove Senadhi COMLEX * Nicole Michelle Sheffield University of Louisville School of Medicine USMLE/TN Anthony Andrew Terreri Uniformed Services Univ of Health Sciences USMLE/IN * Tai Huu Vo Nova Southeastern University COM COMLEX * JaVar Burrell Myatt-Jones Wayne State University SOM USMLE/IL

ABME Public Agenda

1

September 17, 2014

PROVISIONAL ENDORSEMENT Name

Medical School

Endorsement

No Provisional Endorsement Applicants

SPECIAL PURPOSE LICENSE

1 2 3 4 5 6 7

Name

Location

Type of Practice

Ashraf H. Hamdan Muhammad Sami Ismail Hadeer N. Karmo Kathryn Teresa Knight Eric Scott Palmer * John Pieter Tazelaar Donna-Jean Walker

Nashville, TN Nashville, TN Nashville, TN Brentwood, TN Nashville, TN Houston, TX Nashville, TN

Neonatology Neonatology Neonatology Pathology Neonatology Reference Lab Neonatology

III LIMITED LICENSE

1 2 3 4 5

Name

Medical School

Endorsement

Jeffrey Allan DeFoor Ujjwal Kumar Neha Raman Patil Andrew Tyler Smith Kannan Thanikachalam

UASOM Birmingham Maulana Azad Medical Col Univ of Delhi JMF's A.C.P.M. Medical College UASOM Birmingham Stanley Medical College Univof Chennai

LL/AL LL/AL LL/AL LL/AL LL/AL

IV PHYSICIAN ASSISTANTS / ADVANCED PRACTICE NURSES (2) Cover Sheet P.A. License

1 2 3 4 5

Name

School

NCCPA

Jenny Carney Alex Pittman Teresa Price Michael Cilimberg Courtney Henderson

USAM LSU Hlth Sciences Ctr Shreveport Nova Southeastern UAB USAM

1117596 1101402 1041978 1019607 1117604

ABME Public Agenda

2

September 17, 2014

6 7 8 9

Waritta Howell Sandra McCord Jessica Parham Elijah Wells

USAM Emory University UAB USAM

1117608 1090997 1087596 1117629

School

NCCPA

Name

School

NCCPA

Kathleen Barker Cassie Odom

USAM USAM

Registered for Exam Awaiting Exam Results

A.A. License Name No A.A. License Applicants

Temporary P.A. License

1 2

Temporary P.A. License to Full License

1 2 3

Name

School

NCCPA

Lora Emily Banks Ellen Barbour Danielle Leonard

USAM USAM USAM

1117593 1117594 1117614

P.A. Registration No additional duties, no remote site, #2, #21, and #23 (5) (16) (27) (40) (58) (70) (80) (93) (101)

1. 2. 3. 4. 5. 6. 7. 8. 9.

Helen Alexander, PA / Audry Slane, M.D. Melissa Bachman, PA / Wayne Goodson, M.D. Vincent Baglini, PA / Minh Huynh, M.D. #21, #23 Lora Emily Banks, PA / Julio Rios, M.D. #21, #23 Chelsea Bares, PA / Jeremy Lindley, D.O. #23 Jenny Carney, PA / Jeremy Pepper, M.D. #23 Shannon Dunn, PA / Stephanie Pereira, M.D. #23 Jefferson Hicks, PA / Frederick Flandry, M.D. #23 John Hurt, PA / Diamond Vrocher, M.D.

ABME Public Agenda

3

September 17, 2014

(115) (129) (139) (150) (Add) (Add) (Add)

10. 11. 12. 13. 14. 15. 16.

Mark Minton, PA / Hossam Tarakji, M.D. #23 Lonnie Parsons, PA / Gaylon Rogers, M.D. Alex Pittman, PA / Michael Miller, M.D. Lauren Tucker, PA / Stephanie Pereira, M.D. #23 Kathleen Barker, PA / John Galla, M.D. Waritta Howell, PA / Mark Herron, M.D. #2, #23 Elijah Wells, PA / Christopher Frailie, M.D. #23

Additional duties, remote site, formulary requests

P.A. / Physician Registration

Skill; Remote Site; Formulary Requests

(163)

1. Donald Andrews, PA Aaron Hoffman, M.D.

Registration Anticoagulants Thrombolytics

(177)

2. Ellen Barbour, PA William Scott, M.D.

Registration Birth Control Drugs and Devices Ventriculostomy Removal Intracranial Pressure Monitor Bolt Removal Lumbar Puncture Tap Shunts Halo Pin Placement

(192)

3. Jim Blan, PA Marion Sennett, M.D.

Registration Hyperbaric Medicine

(204)

4. Sylvia Eldridge, PA Melanie Petro, M.D.

Registration Birth Control Drugs and Devices Endovenous Ablation of Incompetent Saphenous Vein w/Laser or Radio Frequency Micro-Phlebectomy Sclerotherapy

(228)

5. Lesia Means, PA Dana Todd, M.D.

Registration Birth Control Drugs and Devices Remote Site

(242)

6. Jennifer Penuel, PA Richard Friend, M.D.

Registration Birth Control Drugs and Devices Joint Injections Arthrocentesis

(Add)

7. Michael Cilimberg, PA Aaron Hoffman, M.D.

Registration Anticoagulants Thrombolytics

ABME Public Agenda

4

Recommendation

September 17, 2014

P.A. / Physician Registration

Skill; Remote Site; Formulary Requests

(Add)

8. Barbara Hobbs, PA Bradley Carden, M.D.

Registration Remote Site Birth Control Drugs and Devices

(Add)

9. Barbara Hobbs, PA Ritu Chandra, M.D.

Registration Remote Site Birth Control Drugs and Devices

Recommendation

A.A. Registration No AA registration applicants P.A. Miscellaneous Requests / Reports P.A. / Physician

Skill; Formulary; Misc Requests

Recommendation

(253)

1. Cami Bertus, PA Susan Gibson, M.D. Andrew Hodges, M.D. Robert Williams, M.D.

Add formulary Birth Control Drugs and Devices

(261)

2. Lauryn Borgschulte, PA Michael Blum, M.D.

Documentation of Training: Joint Injections: Shoulder and Knee

(266)

3. Healthstat Inc.

Dispensing of pre-packaged legend drugs

(271)

4. Matthew Herndon, PA Stanton Davis, M.D.

Add remote site

(273)

5. Jeannie Jacobs, PA Robert Gilliam, M.D. Joseph Sewell, M.D.

Add remote site Add covering physician

(280)

6. Derrick Johnson, PA Roland Hester, M.D.

Add Schedules IV and V to QACSC

(283)

7. Daniel Leonard, PA Gary Eberly, M.D.

Add formulary Birth Control Drugs and Devices

(286)

8. Heather Lockhart-Payne, PA Michael Ridner, M.D.

Administration of tumescent anesthesia

(288)

9. Stanley White, PA Rassan Tarabein, M.D.

Documentation of Training: Joint Injections: Shoulder and Knee

(Add)

10. Kimberly Pickett, PA Cary Petry, M.D.

Hormone pellet insertion Remote site privileges

ABME Public Agenda

5

September 17, 2014

P.A. QACSC Registration 1 2 3 4 5 6 7

Thomas Clark, PA / Tony White, M.D. J. Chad Higginbotham, PA / Elias Quintos, M.D. Daniel Spraggins, PA / Cyrus Ghavam, M.D. Kara Caruthers, PA / Rita Goyla, M.D. John Denney, PA / Rhett Murray, M.D. John Hurt, PA / Rita Goyal, M.D. Stephanie McGilvray, PA / Rita Goyal, M.D. APN Miscellaneous Requests / Reports (292) Cover Sheet Physician / CRNP

Skill; Restricted Drug; Misc Requests

(294)

1. Rowell Stanford Ashford, M.D. Loretta Preston, CRNP

Subdermal contraceptives Insertion and Removal

(297)

2. Sammy F. Becdach, M.D. Ashley McBride, CRNP

Antineoplastic agents

(301)

3. Elizabeth Aileen Buffler, M.D. Mary Jennings, CRNP

Cryotherapy of non-pigmented lesions Subdermal contraceptives Insertion and Removal

(304)

4. Ladonna M. Crews, M.D. Natalie S. Fox, CRNP

Cryotherapy of non-pigmented lesions Subdermal contraceptives Insertion and Removal

(306)

5. James Steven Donald, M.D. Glenda Ganus, CRNP

Cryotherapy of non-pigmented lesions Trigger Point Injections Below T-12

(309)

6. Benjamin Steven Favis, M.D. Amye Groves, CRNP

Cryotherapy of non-pigmented lesions

(312)

7. Gregory Kane Friedman, M.D. Jessica Edmondson, CRNP

Antineoplastic agents

(315)

8. Frederick Graham, M.D. Jessicak Hester, CRNP

Trigger Point Injections Below T-12

(317)

9. Xiaosi Han, M.D. Tonya M. Austin, CRNP

Antineoplastic agents Letter of Clarification - Skills request

(324)

10. James Marland Hunter, M.D. Indra Oldham, CRNP

CVL - remove and replace over guide wire

(327)

11. David Edmund James, M.D. Karen Thompson, CRNP

Cryotherapy of non-pigmented lesions Trigger Point Injections Below T-12

ABME Public Agenda

6

Recommendation

September 17, 2014

Physician / CRNP

Skill; Restricted Drug; Misc Requests

(330)

12. Matthew Adam Kutny, M.D. Kathryn Hays, CRNP

Antineoplastic agents

(333)

13. John Philip Lazenby, M.D. Kathryn Langley, CRNP

CVL - remove and replace over guide wire Central lines: IJ and Femoral Arterial lines: Radial and Femoral

(337)

14. Jeffrey David Lebensburger, D.O. Michelle McCaul, CRNP

Antineoplastic agents

(340)

15. Renzo Y. Loyaga-Rendon, M.D. Elizabeth Clark, CRNP

Antineoplastic agents

(343)

16. Keith Christopher Martin, M.D. Karen Aplin, CRNP

Subdermal contraceptives Insertion and Removal

(345)

17. Rajesh V. Patel, D.O. Linda Floyd, CRNP

Trigger Point Injections Below T-12

(348)

18. Herrick J. Siegel, M.D. Karen Cardwell, CRNP

Joint Injections: Knee Shoulder Greater Trochanteric Bursa

(360)

19. Peter Strogov, M.D.

FTE Exemption

(362)

20. Harry Earl Studdard, M.D. Shawna Reich, CRNP

Anti-Rheumatic Drugs: Non-Biologic DMARDS

(365)

21. Alvin Virtudazo Tenchavez, M.D. Michael Murdock, CRNP

Cryotherapy of non-pigmented lesions

Recommendation

Collaborative Practice Registration (Add) Collaborative Practice Registration (Add) Princess Natasha Robinson Humphrey, M.D. / Terri Lynn Hallman, CRNP

Collaborative Practice Covering Physician Applicants (Add) Collaborative Practice Covering Physician Applicants

CRNP QACSC Registration (Add) CRNP QACSC Registration Applicants

ABME Public Agenda

7

September 17, 2014

Physician Assistant Advisory Committee Physician Assistant Advisory Committee- September 16, 2014, 5:00 p.m.

V CURRENT BUSINESS (2) (3) (4) (55) (60) (74) (75) (78)

1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. (Add) 13.

Advisory Committee on QACSCs for CRNPs / CNMs ABMS Maintenance of Certification American with Disabilities Act / Licensure Application Questions Electronic Prescription of Controlled Substances Hormone Pellet Therapy PA Registration Fee / Free Medical Clinics Teladoc Correspondence - Timothy E. Hughes, M.D. 2014 - 2015 Lease Contract 2014 - 2015 Alabama Physician Health Program Contract 2014 - 2015 Medical Association Contract for Education Services 2015 Medical Foundation of Alabama Contract for Education Services UAB - eMedicine / E-Visit

PERSONNEL No Personnel matters

VI HEARINGS (2)

ABME Hearing Schedule

(3) 1. Timothy Marshal Iliff, M.D., Atmore Show Cause Hearing 2. William E. Feist, M.D., Birmingham Reconvene Hearing Panel

ABME Public Agenda

September 17, 2014, 12:30 p.m.

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September 17, 2014

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