6810.1 An applicant for an initial license or renewal of a license to practice podiatry shall provide to the Board of Podiatry the following information within thirty (30) days from the date of the initial application or renewal or, change in the following information:

1. (a) The address and telephone number of the primary practice setting and all secondary practice settings with the percentage of time spent at each location;
2. (b) The names of schools of podiatry and graduate podiatric education programs attended with dates of graduation or completion of training;
3. (c) The names and dates of specialty Board certification, if any, as approved by the American Podiatry Association, the American Podiatric Medical Association, the American Association of Colleges of Podiatric Medicine, or the American Academy of Podiatric Sports Medicine;
4. (d) The number of years in active, clinical practice in the United States or Canada following completion of podiatric training and the number of years, if any, in active, clinical practice outside the United States or Canada;
5. (e) The area of specialty, if any, in which the podiatrist practices;
6. (f) The names of hospitals with which the podiatrist is affiliated;
7. (g) Appointments, if applicable, within the past ten (10) years to podiatric school faculties with the years of service and academic rank;
8. (h) Publications, not to exceed ten (10) in number, in peer-reviewed literature within the most recent five-year period, to be supplied at the physician's discretion;
9. (i) Access, if any, to translating services for non-English speaking patients at the primary and secondary practice setting and which, if any, foreign languages are spoken in the practice;
10. (j) Whether the podiatrist participates in the District Medicaid and Medicare programs and whether he or she is accepting new Medicaid and Medicare patients, or D.C. Health Alliance;
11. (k) The names of insurances accepted by the podiatrist, to be supplied at the podiatrist's discretion;
12. (l) Information on misdemeanor and felony convictions including the date(s) of the conviction, the nature of the conviction, the jurisdiction in which the conviction occurred, and the sentence imposed, if any;
13. (m) Within the last ten (10) years, final orders of any regulatory board of another jurisdiction that resulted in the denial, probation, revocation, suspension, or restriction of any license or that resulted in the reprimand or censure of any licensure, fines imposed, or the voluntary surrender of a license while under investigation in a jurisdiction other than the District of Columbia, restriction or termination of privileges at a healthcare facility as a result of peer review action, as well as any disciplinary action taken by a federal health institution or federal agency; and
14. (n) The date, amount, and description of any malpractice settlement amount or payout

resulting from a judgment made within the last ten (10) years.

SOURCE: Final Rulemaking published at 35 DCR 955, 959 (February 12, 1988); as amended by Notice of Final Rulemaking published at 54 DCR 8072 (August 17, 2007).