Individual provider Active NPI

Shanise Gibson, RN

  • Administrator Registered Nurse
  • Rock Hill, SC
National Provider Identifier
1093643223
Registry record updated May 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Administrator Registered NurseTaxonomy code 163WA2000X
License
273853 Issued in SC
Practice address
1565 Ebenezer Rd Ste 111
Rock Hill, SC 29732-2494
Phone
(803) 376-3474
NPI assigned
May 9, 2026
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 9, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Administrator Registered Nurse 163WA2000X 273853 SC Primary

Addresses

Primary practice location

1565 Ebenezer Rd Ste 111
Rock Hill, SC 29732-2494

Mailing address

436 Dutch White Dr
Clover, SC 29710-6926

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
273853SCMDAdministrator Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Truewell Homecare & Support Services, LLC Administrator Current Accepting new patients

Locations

1565 Ebenezer Rd
Ste 111
Rock Hill, SC 29732
Phone (803) 376-3474

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1778284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778284800000",
    "number": "1093643223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "436 DUTCH WHITE DR",
            "city": "CLOVER",
            "state": "SC",
            "postal_code": "297106926"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1565 EBENEZER RD STE 111",
            "city": "ROCK HILL",
            "state": "SC",
            "postal_code": "297322494",
            "telephone_number": "803-376-3474"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBSON",
        "first_name": "SHANISE",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-05-09",
        "last_updated": "2026-05-09",
        "certification_date": "2026-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WA2000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Administrator",
            "state": "SC",
            "license": "273853",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rock Hill, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.