The Collaboration Ledger · 2026-W39
One physician, three NPs: where the supervision math runs out
This week's ledger is about headcount. Eleven jurisdictions limit how many nurse practitioners a single physician may cover, and in Nevada the ceiling is three. A DEA decision and order involving an APRN registrant also landed on the federal docket.
On the docket
Federal: DEA issues a decision and order in the matter of an APRN registrant
The Drug Enforcement Administration published a decision and order concerning Emran Mohammad, RN, APRN, CNP, in the Federal Register on September 11. For nurse practitioners, DEA registration sits alongside state prescriptive authority: a federal action on a registration reaches your ability to prescribe controlled substances regardless of how your state handles collaboration.
Independent Practice: Nurse Practitioner
Source: Federal Register: Emran Mohammad, RN, APRN, CNP; Decision and Order
The tightest supervision ratios for nurse practitioners
11 jurisdictions cap how many nurse practitioners one physician may supervise or collaborate with; these are the lowest caps on file.
Nevada: 3 per physician (combined across provider types)
The lowest cap on file. Because it counts provider types together, every PA or other advanced practice clinician your physician already covers narrows the room left for you.
California: 4 per physician
Four nurse practitioners to a physician. In a group where one physician signs for the whole clinic, the cap decides how many NPs that clinic can staff under agreements.
New York: 4 per physician
Also four. If your collaborating physician is already at the limit, a new hire means finding another signer rather than amending the existing agreement.
Ohio: 5 per physician (combined across provider types)
Five, counted across provider types, so PAs share the same allowance as nurse practitioners.
Missouri: 6 per physician (combined across provider types)
Six across provider types. Worth checking against your physician's other signed agreements before you count on an open slot.
Oklahoma: 6 per physician (combined across provider types)
Six, likewise combined. The cap is a practical limit on how many NPs one physician can support in a rural network.
Every outside claim carries the source it was read from this week. Our own research dates are on each state page. Published 2026-09-21.