Credentialing Application Process - Surgical Assistant

By requesting an application from Piedmont Healthcare, you certify that you meet the following minimum requirements:

• You must have a current, unrestricted license, certification, or registration to practice in Georgia (if applicable) and have never had a license, certification, or registration to practice revoked or suspended by any state licensing agency;
• You must have current, valid professional liability insurance coverage in such form and in amounts satisfactory to the Board;
• You must have never been convicted of, or entered a plea of guilty or no contest to, Medicare, Medicaid, or other federal or state governmental or private third-party payer fraud or program abuse, nor have been required to pay civil monetary penalties for the same;
• You must have never been, and are not currently, excluded, precluded, or debarred from participation in Medicare, Medicaid, or other federal or state governmental health care program;
• You must have never had clinical privileges or scope of practice denied, revoked, or terminated by any health care facility or health plan for reasons related to clinical competence or professional conduct;
• You must have never relinquished or resigned affiliation, clinical privileges, or a scope of practice during an investigation or in exchange for not conducting such an investigation;
• You must have never been convicted of, or entered a plea of guilty or no contest to, any felony; or to any misdemeanor relating to controlled substances, illegal drugs, insurance or health care fraud or abuse, child abuse, elder abuse, or violence;
• You must satisfy all additional eligibility qualifications relating to the specific area of practice that may be established by the Hospital;
• You must have a supervision agreement with a physician who is appointed to the Medical Staff (the “Supervising Physician”) of the same Piedmont Healthcare facility to which you will be applying.

If the above requirements are met, you should complete our request for the application questionnaire. 

Start Application

If you would like more about a particular Piedmont Healthcare facility or have questions about the application process, please email piedmontmedical.staffoffice@piedmont.org.