Provider Demographics
NPI:1205587763
Name:ROGERS GATHERS, JONI (RN)
Entity type:Individual
Prefix:
First Name:JONI
Middle Name:
Last Name:ROGERS GATHERS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:78 SATURN DR
Mailing Address - Street 2:
Mailing Address - City:HEMINGWAY
Mailing Address - State:SC
Mailing Address - Zip Code:29554-6021
Mailing Address - Country:US
Mailing Address - Phone:843-618-8796
Mailing Address - Fax:
Practice Address - Street 1:78 SATURN DR
Practice Address - Street 2:
Practice Address - City:HEMINGWAY
Practice Address - State:SC
Practice Address - Zip Code:29554-6021
Practice Address - Country:US
Practice Address - Phone:843-618-8796
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-15
Last Update Date:2025-01-08
Deactivation Date:2024-12-11
Deactivation Code:
Reactivation Date:2025-01-08
Provider Licenses
StateLicense IDTaxonomies
SC236918163W00000X, 163WH0500X
SC29720363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered NurseGroup - Single Specialty
No163WH0500XNursing Service ProvidersRegistered NurseHemodialysisGroup - Single Specialty