Individual provider Active NPI

Gretchen L Hanson, CNNP

  • Neonatal Nurse Practitioner
  • Maplewood, MN
National Provider Identifier
1023074655
Registry record updated Jul 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal Nurse PractitionerTaxonomy code 363LN0000X
License
R1402513 Issued in MN
Practice address
1575 Beam Ave
Maplewood, MN 55109-1126
Phone
(651) 232-7000
NPI assigned
Apr 22, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Neonatal Nurse Practitioner 363LN0005X R1402513 MN
Neonatal Nurse Practitioner 363LN0000X R1402513 MN Primary

Addresses

Primary practice location

1575 Beam Ave
Maplewood, MN 55109-1126

Mailing address

2910 Centre Pointe Drive
35-121A Childrens Health Care
Roseville, MN 55113
Phone (651) 855-2327

Other practice location 1

347 North Smith Avenue
Childrens Specialty Clinic - NICU
St Paul, MN 55102
Phone (651) 220-6210

Other identifiers 1

IdentifierTypeStateIssuer
305435700MedicaidMN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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 1

Enrollment IDStateProvider typePAC IDDetails
I20210729000559 MN Practitioner - Nurse Practitioner 2567865488 Reassigns benefits to 4 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
R1402513MNMDCritical Care Neonatal Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Healtheast Medical Research Institute CurrentSince Dec 1, 2024 Accepting new patients
Fairview Health Services CurrentSince Jul 1, 2021 Accepting new patients
Fairview Health Services Current Accepting new patients
Fairview Express Care Current Accepting new patients
Fairview Health Services CurrentSince Jul 1, 2021 Accepting new patients
Healtheast Medical Research Institute Current Accepting new patients
Fairview Express Care CurrentSince Jul 1, 2021 Accepting new patients
Fairview Clinics Current Accepting new patients
Fairview Clinics CurrentSince Jul 1, 2021 Accepting new patients
Fairview Clinics CurrentSince Jul 1, 2021 Accepting new patients
Fairview Express Care CurrentSince Jul 1, 2021 Accepting new patients
Healtheast Medical Research Institute CurrentSince Dec 1, 2024 Accepting new patients
Allina Health System Past Accepting new patients
Regions Hospital Past Accepting new patients

Locations

201 E Nicollet Blvd
Burnsville, MN 55337
Phone (952) 892-2000

1440 Duckwood Dr
Eagan, MN 55122
Phone (651) 406-8860

550 Osborne Rd NE
Minneapolis, MN 55432
Phone (763) 236-3800

717 Delaware St SE
Ste 340
Minneapolis, MN 55414
Phone (612) 625-3617

2450 Riverside Ave
Minneapolis, MN 55454
Phone (612) 273-7838

6401 France Ave S
Minneapolis, MN 55435
Phone (952) 920-8477

911 Northland Dr
Princeton, MN 55371
Phone (763) 389-1313

1700 University Ave W
Saint Paul, MN 55104
Phone (612) 672-6740

2945 Hazelwood St
Ste 100
Saint Paul, MN 55109
Phone (651) 232-7800

1700 University Ave W
Fl 6
Saint Paul, MN 55104
Phone (651) 232-2273

1575 Beam Ave
Saint Paul, MN 55109
Phone (651) 232-7000

1925 Woodwinds Dr
Woodbury, MN 55125
Phone (651) 232-0100

Organizations & group practices 15

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.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1145664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626739200000",
    "number": "1023074655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2910 CENTRE POINTE DRIVE",
            "address_2": "35-121A CHILDRENS HEALTH CARE",
            "city": "ROSEVILLE",
            "state": "MN",
            "postal_code": "55113",
            "telephone_number": "651-855-2327",
            "fax_number": "651-855-2310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1575 BEAM AVE",
            "city": "MAPLEWOOD",
            "state": "MN",
            "postal_code": "551091126",
            "telephone_number": "651-232-7000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "347 North Smith Avenue",
            "address_2": "Childrens Specialty Clinic - NICU",
            "address_purpose": "LOCATION",
            "city": "St Paul",
            "state": "MN",
            "postal_code": "55102",
            "country_code": "US",
            "telephone_number": "651-220-6210",
            "fax_number": "651-220-7777",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HANSON",
        "first_name": "GRETCHEN",
        "middle_name": "L",
        "credential": "CNNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-22",
        "last_updated": "2021-07-20",
        "certification_date": "2021-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LN0005X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal, Critical Care",
            "state": "MN",
            "license": "R1402513",
            "primary": false
        },
        {
            "code": "363LN0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal",
            "state": "MN",
            "license": "R1402513",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "305435700",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Maplewood, MN

Sources for this page

Verify at the official NPI Registry.