Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Gershom Jacob Douglas, APNP

Individual provider Nurse Practitioner · NPI 1902568942

Gershom Jacob Douglas, APNP is a Nurse Practitioner in Gaffney, South Carolina. Qualified in 2021, 5 years ago. Practices with Nephrology Associates of the Carolinas PA, a 6-clinician group and accepts Medicare assignment. Licensed in South Carolina and Wisconsin.

Years since qualifying
5
Licensed in
SC, WI
In the registry since
2021
Specialties on file
2

Practice location Address checks out

1506 N Limestone St Ste B
Gaffney, SC 29340-4747
Phone: (864) 489-4498
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X · Licence 27568 (SC)
Nurse Practitioner Taxonomy 363L00000X · Licence 1135733 (WI)

Record details

NPI number1902568942
Entity typeIndividual (Type 1)
GenderMale
Credentials APNP
Sole proprietorYes
NPI enumeratedOctober 7, 2021
Last updated in NPPESSeptember 14, 2023
Certification dateSeptember 14, 2023

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice Nephrology Associates Of The Carolinas Pa — 6 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Gaffney