Individual provider Active NPI

Nichole Shiontaine Gaines, FNP

  • Family Nurse Practitioner
  • Rock Hill, SC
National Provider Identifier
1326876475
Registry record updated Sep 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
29312 Issued in SC
Practice address
2275 India Hook Rd
Rock Hill, SC 29732-1223
Phone
(803) 329-1500
NPI assigned
Jul 22, 2024
Last updated
Sep 24, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 24, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 29312 SC Primary

Addresses

Primary practice location

2275 India Hook Rd
Rock Hill, SC 29732-1223

Mailing address

13500 Thicket CT
Charlotte, NC 28273-6749
Phone (704) 608-1186

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC, NC2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20241119004506 SC Practitioner - Nurse Practitioner 6103351721 Reassigns benefits to 1 organization
I20250318001802 NC Practitioner - Nurse Practitioner 6103351721 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carolinas Physicians Network IncGroup PAC ID 3375449655, 2,324 clinicians

Practice addresses (Care Compare)

10628 Park Rd
Charlotte, NC 28210-8407
Phone (704) 667-7070

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Carolinas Physicians Network Inc CurrentSince Mar 10, 2025 Accepting new patients
Carolinas Physicians Network Inc Current Accepting new patients
Carolina Community Care Inc Family Medicine CurrentSince Aug 11, 2024 Accepting new patients
Carolina Community Care, Inc. CurrentSince Sep 1, 2024 Accepting new patients
Carolinas Physicians Network Inc CurrentSince Mar 10, 2025 Accepting new patients

Locations

1000 Blythe Blvd
Charlotte, NC 28203
Phone (704) 351-3791

10628 Park Rd
Charlotte, NC 28210
Phone (704) 543-2000

2275 India Hook Rd
Rock Hill, SC 29732
Phone (803) 329-1500

Interoperability endpoints

  • Direct secure messaging: ngaines1174802@carolinashealthcaresystem.direct-ci.com

Organizations & group practices 5

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

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1721606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727136000000",
    "number": "1326876475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13500 THICKET CT",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282736749",
            "telephone_number": "704-608-1186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2275 INDIA HOOK RD",
            "city": "ROCK HILL",
            "state": "SC",
            "postal_code": "297321223",
            "telephone_number": "803-329-1500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAINES",
        "first_name": "NICHOLE",
        "middle_name": "SHIONTAINE",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-07-22",
        "last_updated": "2024-09-24",
        "certification_date": "2024-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "29312",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rock Hill, SC

Sources for this page

Verify at the official NPI Registry.