Enacts GS 90-9.3A to require a physician assistant (PA) to execute and maintain a supervisory agreement with a physician, unless the PA practices in team-based settings and has more than 4,000 hours of practice experience as a licensed PA and more than 1,000 hours of practice within the specific medical specialty of practice with a physician in that specialty. Details required content of the supervisory arrangement and requires the arrangement to be made available to the Board immediately upon request. Requires PAs subject to supervisory arrangements to submit an "Intent to Practice Notification Form" to the NC Medical Board (Board) before initiating the practice of medical acts, tasks, or functions of a PA, as specified. Requires PAs to collaborate and consult with or refer to appropriate team members as required and specified. Explicitly deems a PA responsible for the care they provide. Mandates supervision of a PA practicing in a perioperative setting, including the provision of surgical or anesthesia-related services. Makes conforming changes to the PA licensure requirements under GS 90-9.3, and the PA limited volunteer licensure requirements under GS 90-12.4.

Adds team-based setting to the defined terms in GS 90-1.1, defining the terms to mean either a medical practice organized under GS 55B-14(c)(3); a physician-owned medical practice where the owner has consistent and meaningful participation in the design and implementation of health services to patients; and licensed health facilities with active credentialing and quality programs where physicians have consistent and meaningful participation in the design and implementation of health services to patients; excludes medical practice that specializes in pain management. Amends the practice of medicine or surgery to include using the designation "Physician Assistant" or "PA" as specified. 

Makes a technical change to the title of GS 90-12.4B.

Modifies the limitations set forth for PAs in GS 90-18.1 as follows. Allows a person meeting the qualifications for PA licensure to use the title, but prohibits acting or practicing as a PA unless licensed under the Chapter. Adds a new requirement for PAs to clearly designate their credentials in all clinical settings. Makes clarifications to the prescription drug authorities granted to indicate that the required provision of instructions and policies by the supervising physician only applies to PAs subject to supervisory agreements. Requires personal consultation with a physician (rather than the supervising physician) for the prescription of a targeted controlled substance under certain conditions, as previously described. Makes conforming changes. Makes clarifications to a PA's authority to order medications, tests and treatment in hospitals, clinics, nursing homes, and other health facilities to specify that the provision of instructions and review by a supervising physician only applies if the PA is subject to a supervisory agreement. Grants new authority for a PA to prescribe, dispense, compound, order, administer, and procure drugs and medical services, and plan and initiate a therapeutic regimen that includes ordering and prescribing non-pharmacological interventions and diagnostic support services. Authorizes PAs to authenticate any document, including death certificates with their signature, certification, stamp, verification, affidavit, or endorsement to the same extent as a physician. Bars PAs from performing final interpretations of diagnostic imaging studies, as defined, which must be provided by a licensed physician subject to the supervision of the Board. Makes conforming changes. 

Amends GS 90-21.81 to include a PA with certification in obstetrical ultrasonography in the defined term qualified technician, as used in Article 1I, Woman's Right to Know Act.

Amends GS 58-3-169 to include a PA primarily responsible for the care of a mother and her newborn child in accordance with State licensure and certification laws in the defined term attending provider, as used in the statute governing required coverage for minimum hospital stay following birth. 

Expands GS 110-91 to allow a PA to conduct the health assessment of a child required prior to or immediately following admission to a child care facility. 

Effective January 1, 2022.