Are there any proximity or in-person requirements between an NP and collaborating physician in North Carolina?

In North Carolina, there is no specific proximity or in-person requirement between an NP and the collaborating (supervising) physician; instead, they must be continuously available to each other via direct communication or telecommunication¹. In other words, physical co-location is not required so long as the physician and NP maintain continuous availability for consultation¹.

A personal consultation with the supervising physician prior to prescribing a targeted controlled substance is required only when both conditions apply: the patient is being treated by a pain-management facility that primarily engages in prescribing narcotic medications or advertises pain management services, and the therapeutic use of the targeted controlled substance will or is expected to exceed 30 days; the consultation may occur either in person or electronically and must be documented in the patient record². When such targeted controlled substances are prescribed continuously, the NP must consult with the supervising physician at least every 90 days to confirm the prescription remains medically appropriate³.

While there is no distance rule, North Carolina requires structured collaboration, including monthly meetings during the first six months of a new collaborative practice and semiannual quality improvement meetings; the rules do not specify that these meetings must be in person⁴⁵.