FAQs
Do NPs need a supervising physician in North Carolina?
North Carolina
Nurse Practitioner Collaboration

Do NPs need a supervising physician in North Carolina?

Chris Turitzin
•
Updated
March 6, 2026

Yes. NPs in North Carolina need a supervising physician to practice; specifically, an NP must maintain a collaborative practice agreement with a primary supervising physician to perform medical acts1. That agreement establishes ongoing supervision, consultation, collaboration, referral, and evaluation of care between the NP and physician2.

Supervision is defined as the physician’s function of overseeing NP medical acts, and the NP and supervising (or back-up) physician must be continuously available to each other for consultation by direct communication or telecommunication34. If the collaborative practice agreement ends, the NP’s approval to practice is terminated5.

Citations

  1. 21 N.C. Admin. Code 36 .0804(a)(4)
  2. 21 N.C. Admin. Code 36 .0801(4)
  3. 21 N.C. Admin. Code 36 .0801(12)
  4. 21 N.C. Admin. Code 36 .0810(1)
  5. 21 N.C. Admin. Code 36 .0804(d)
Chris Turitzin
Chris, founded Single Aim Health in 2024 to provide clinicians, especially NPs and PAs, with essential services for launching and growing their practices. A Stanford graduate in Product Design, Chris co-founded Momentus Media, which was acquired by Facebook, and worked as a Product Manager there. He later gained expertise in digital health through leadership roles at Bicycle Health, Virta Health, and founding Wink Health. Now, he is using his experience to help clinicians through Single Aim Health.
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Disclaimer: The regulatory research, summaries, and tools provided by Single Aim, LLC are for informational and educational purposes only and do not constitute legal advice. While we strive to ensure accuracy, healthcare laws vary by state and may change over time. You should always consult a licensed attorney familiar with healthcare regulations in your specific state before making decisions related to you clinical and operational needs for compliance. Single Aim is not a law firm and does not provide legal representation. Use of our materials does not create an attorney-client relationship.

Need legal guidance? We recommend contacting a licensed healthcare attorney in your state or using professional associations such as the American Health Law Association (AHLA) or your state’s medical or nursing board for referrals.