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After being formally structured and organized in 1974, the National Commission on Certification of Physician Assistants (NCCPA) was incorporated and opened offices in Atlanta, Georgia in 1975. NCCPA is the only credentialing organization for physician assistants in the United States, and is dedicated to assuring the public that certified physician assistants meet established standards of knowledge and clinical skills upon entry into practice and throughout their careers. Its Board of Directors includes appointees from 14 participating organizations, as well as three members-at-large. After passing the Physician Assistant National Certifying Examination (PANCE), physician assistants are issued an NCCPA certificate, entitling them to the use of the Physician Assistant-Certified (PA-C) designation until the expiration date printed on the certificate (approximately two years). To remain certified, PAs must log 100 hours of continuing medical education every two years and complete the Physician Assistant National Recertification Exam (PANRE) every ten years.