Application Status Query

Instructions: 

Please allow one hour after receipt of your status update email for the updates to be reflected in the online checklist.

Please verify the checklist information below, including your address. If your address has changed, please e-mail your application number, name, profession, along with your old and new address. The Credentialing department posts status information following receipt and review of application materials.

As of  :  11/23/2021
Application#  :  761924
Name  :  Niemyjski, Shallin R
Profession  :  Physical Therapist Assistant
Address  :  Burlington, WI
Application Status  :  (Permanent license issued)


Requirements Not Met:
Description Status Comments (Please note, not all requirements will include comments)

Requirements Met:
Description Status Comments (Please note, not all requirements will include comments)
Wisconsin Statutes & Rules Examination Met
9/28/21: WIOB Pass - /kb;
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8/9/21: You may take this exam at any time;
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Prior to taking exam, review instructions at:
https://dsps.wi.gov/Pages/Professions/PT/Exams.aspx
When at the ParTest Online you will need the following:
Instructor: gsp
Test Name: PTA13A
Test Password: PTA13A
Student ID: Your application ID
Due to Wisconsin Administrative Code changes, two questions in the PT13A exam are no longer valid. Because we are in the midst of a pandemic and physical therapists and therapist assistants play a significant role in the health of Wisconsin residents, DSPS has decided to provide examinees with the answers to the outdated questions during this time to avoid the amount of down time it typically takes to update and change exam questions in the ParTest Online System. Please use the answers to the questions below as you complete your examination.
Question 23: B
Question 26: C
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PLEASE NOTE: each attempt of this exam cost $75.00. If you receive a failing score you will be required to retake this exam & pay the $75.00 retake fee – /kb
Application Complete Met
11/23/21: complete - TMB;
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4/29/21: Your application has been received & entered. Your application has not been reviewed. (Requirements will remain "Not Met" until your application has been reviewed.) Initial application review may take at least 3 weeks from the date your application was entered into the system. Thank you - (DVM)
Application Fee Met
$158
Certificate of professional education (Form #3196) Met
9/29/21: MET - /kb;
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8/9/21: need school to complete AFTER you graduate, print form 3196 at: https://dsps.wi.gov/Pages/Professions/PT/Default.aspx – /kb
NPTE results Met
8/9/21 NPTE Pass /kb
Information on Conviction(s)/Pending Charge(s) (Form #2252) Met
11/23/21: complete - TMB;
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11/9/21: If all other requirements are met, the credential can be issued. CSK;
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11/3/21: Application sent to Legal for review. Applications are reviewed as promptly as possible, but review times do vary depending on a variety of factors. Due to a high volume of files needing legal review, review times may take up to 12 weeks based on complexity of the file. If further information is needed, you will be contacted. If you have questions, you may email DSPS@wi.gov or call (608) 266-2112. Please allow 12 weeks from the time your file was sent for legal review if you have not seen any updates on your application. Please note, applications that have statutory timeframes for review are being handled accordingly – /kb;
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9/29/21: Please provide a personal statement - /kb;
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8/9/21: Please submit additional $8.00 CIB fee along with form #2252 (available here: https://dsps.wi.gov/Credentialing/General/FM2252.pdf) to DSPS via mail by check to Attn: Joint BD Section PO Box 8935, Madison, WI 53708, or via fax by payment form 3071 to the secured number on that form.
Be sure to include all information and documentation as required on page one of form #2252. If documentation cannot be provided, please be sure to include a statement regarding why the documentation cannot be provided. If your convictions/charges were related to drug and/or alcohol, please be sure to include a current usage statement regarding your current relationship with drugs and/or alcohol and an AODA assessment if ordered by the court – /kb
FBI FINGERPRINTS Met
9/28/21: Complete - /kb;
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8/9/21: To obtain digital Fingerprints, please schedule an appointment with Fieldprint via their website at: https://www.fieldprintwisconsin.com/. The digital fingerprints will cost $34.74 & is expected at the time of your reservation.
-- Use the Fieldprint code FPWIPhysician & account number G3448 when prompted.
-- If you live OUTSIDE of Wisconsin be sure to use the Wisconsin code listed above; you may electronically submit fingerprints at any Fieldprint site near you.
-- AFTER fingerprinting has occurred; PLEASE send an email, put FINGERPRINTS in the SUBJECT line & in the email indicate the DATE your fingerprints were processed & TCN# provided by Fieldprint to: dspscredphysicaltherapy@wi.gov – /kb