1. Home
  2. Directory
  3. North Carolina
  4. Shelby
  5. Nurse Practitioner
  6. NPI Profile
Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

GERSHOM JACOB DOUGLAS APNP
NPI 1902568942
Nurse Practitioner in Shelby, NC

Active since October 07, 2021PECOS EnrolledAccepts Medicare Assignment
1019 N LAFAYETTE ST STE 1, SHELBY, NC 28150(704) 487-9766(704) 487-9891 Get Directions Write a Review

NPPES record last updated: October 14, 2026. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Oct 14, 2026, Oct 17, 2022, Jul 27, 2022 and 1 more (4 updates tracked since 2021).

About Gershom Jacob Douglas Apnp NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

GERSHOM JACOB DOUGLAS APNP (NPI 1902568942) is an individual nurse practitioner in Shelby, North Carolina, licensed in North Carolina (5019427) and active in the NPI registry since October 2021. He is enrolled in Medicare PECOS, is affiliated with Atrium Health Cleveland, and is a graduate of Other (2021).

NPPES Registry Identity

NPI1902568942
Entity TypeIndividualMale
Primary Taxonomy363L00000X
Provider Legal NameGERSHOM JACOB DOUGLASCredential: APNP
Location Address1019 N LAFAYETTE ST STE 1Shelby, NC 28150-3746
Mailing Address1019 N Lafayette St Ste 1Shelby, NC 28150-3746 · (704) 481-7904 · Fax (704) 487-9891
Phone(704) 487-9766
Fax(704) 487-9891
Sole ProprietorYes
Medical School CMSOtherGraduated 2021
Enumeration DateOctober 7, 2021
Last NPPES UpdateOctober 14, 20264 updates tracked since enumeration
NPPES CertifiedOctober 14, 2026
✔ NPI 1902568942 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363L00000X
License✔ Licensed in NC · 5019427
Definition
(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.
1019 N LAFAYETTE ST STE 1, Shelby, NC 28150
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include AmeriHealth Caritas Next, Blue Cross and Blue Shield of NC, UnitedHealthcare.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Gershom Jacob Douglas Apnp is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID1658753538
PECOS Enrollment IDI20240313000122
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

2

Medicare enrollment records show Gershom Douglas reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Nephrology Associates Of The Carolinas, P.A.
Same address
Nephrology
1019 N LAFAYETTE ST, SUITE 1
Shelby, NC 28150
  • Reassigned Medicare billing, North Carolina enrollment
  • Medicare enrollment name: Nephrology Associates Of The Carolinas PA
  • 14 clinicians in this Medicare group
NPI 1598779803 (704) 487-9766
Ear Nose Throat & Audiology Associates
37 mi
Otolaryngology
744 ARDEN LN, SUITE 200
Rock Hill, SC 29732
  • Reassigned Medicare billing, South Carolina enrollment
  • 6 clinicians in this Medicare group
NPI 1366632655 (803) 328-3686

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
92 services81 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Atrium Health Cleveland

Acute Care Hospitals · Shelby, NC
3/5 CMS rating
OwnershipGovernment - Hospital District or Authority
CMS Certification Number340021
Location201 E Grover StShelby, NC 28150 · Cleveland County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 28150 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$83.90 typical visit price
range $54.12 – $165.09
Typical copayment $20.97 (range $13.53 – $41.27)
Most-billed visit code 99203
Established Patient
$95.94 typical visit price
range $17.21 – $134.61
Typical copayment $23.98 (range $4.30 – $33.65)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SANDRA GABRIELA CARIAS ZUNIGA MD
Internal Medicine (Nephrology)
1019 N LAFAYETTE ST STE 1
SHELBY, NC 28150
Cleveland County (704) 487-9766
JOSE DANIEL MENA PASQUEL MD
Internal Medicine (Nephrology)
1019 N LAFAYETTE ST STE 1
SHELBY, NC 28150
Cleveland County (704) 487-9766
VIJAYA CHELIKANI MD
Internal Medicine (Nephrology)
1019 N LAFAYETTE ST STE 1
SHELBY, NC 28150
Cleveland County (704) 481-7904
MAHAM ALI MD
Internal Medicine (Nephrology)
1019 N LAFAYETTE ST STE 1
SHELBY, NC 28150
Cleveland County (704) 487-9766

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Gershom Douglas's NPI number?

The NPI number for Gershom Douglas is 1902568942. It was assigned to this individual provider in the NPPES registry on October 7, 2021.

Where is Gershom Douglas located?

Gershom Douglas practices at 1019 N Lafayette St Ste 1, Shelby, NC 28150. The listed phone number is (704) 487-9766.

What is Gershom Douglas's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Is Gershom Douglas enrolled in Medicare?

Yes. Gershom Douglas is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Gershom Douglas's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Gershom Douglas reassigns Medicare benefits to 2 organizations: Nephrology Associates Of The Carolinas, P.A. (Shelby, NC) and Ear Nose Throat & Audiology Associates (Rock Hill, SC). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Gershom Douglas's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Gershom Douglas accept?

Health plans from AmeriHealth Caritas Next, Blue Cross and Blue Shield of NC and UnitedHealthcare list Gershom Douglas as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Gershom Douglas affiliated with any hospitals?

According to CMS data, Gershom Douglas is affiliated with Atrium Health Cleveland.

When was this NPI record last updated?

The NPPES record for Gershom Douglas was last updated on October 14, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.