Individual provider Active NPI

Christina Grace Duckworth, PA-C

  • Physician Assistant
  • Pensacola, FL
National Provider Identifier
1104579242
Registry record updated Jan 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
4724 N Davis Hwy
Pensacola, FL 32503-2339
Phone
(850) 696-4000
NPI assigned
Jan 29, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

4724 N Davis Hwy
Pensacola, FL 32503-2339

Mailing address

366 El Matador TRL
Pensacola, FL 32506-6006

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, MN, WI3 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 3

Enrollment IDStateProvider typePAC IDDetails
I20220301002022 FL Practitioner - Physician Assistant 2264826676
I20240731003169 MN Practitioner - Physician Assistant 2264826676 Reassigns benefits to 1 organization
I20250508000444 WI Practitioner - Physician Assistant 2264826676 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Florida State University College of Medicine, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Minnesota Oncology Hematology PAGroup PAC ID 6709799752, 131 clinicians

Practice addresses (Care Compare)

1580 Beam Ave
Maplewood, MN 55109-1127
Phone (651) 779-7978

6025 Lake Rd
Suite 110
Woodbury, MN 55125-1709
Phone (651) 735-7414

Hospital & facility affiliations

  • Allina United Hospital Hospital, Saint Paul, MN, CCN 240038
  • Abbott Northwestern Hospital Hospital, Minneapolis, MN, CCN 240057

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Minnesota Oncology Hematology, PA CurrentSince Mar 6, 2025 Accepting new patients
Minnesota Oncology Hematology PA CurrentSince Jul 22, 2024 Accepting new patients
Minnesota Oncology Hematology PA CurrentSince Jul 22, 2024 Accepting new patients
Minnesota Oncology Hematology PA PastSince Jan 14, 2024 Accepting new patients

Locations

1175 Paysphere Cir
Chicago, IL 60674

675 E Nicollet Blvd
Ste 100
Burnsville, MN 55337
Phone (952) 435-8516

110105 Pioneer Trl W
Ste 302
Chaska, MN 55318
Phone (952) 361-5800

10150 Niagara Ln N
#100
Maple Grove, MN 55369
Phone (763) 220-1316

11850 Blackfoot St NW
Ste 100
Minneapolis, MN 55433
Phone (763) 712-2100

6545 France Ave S
Ste 210
Minneapolis, MN 55435
Phone (952) 928-2900

910 E 26th St
Ste 100200
Minneapolis, MN 55404
Phone (612) 884-6300

480 Osborne Rd NE
Ste 220
Minneapolis, MN 55432
Phone (763) 786-1620

2805 Campus Dr
Ste 105
Plymouth, MN 55441
Phone (763) 519-7440

2550 University Ave W
Ste 110N
Saint Paul, MN 55114
Phone (651) 602-5309

1580 Beam Ave
Saint Paul, MN 55109
Phone (651) 255-8480

310 Smith Ave N
Ste 100
Saint Paul, MN 55102
Phone (651) 251-5500

2550 University Ave W
Ste 105N
Saint Paul, MN 55114
Phone (651) 602-5335

560 S Maple St
Ste 100
Waconia, MN 55387
Phone (952) 442-6006

6025 Lake Rd
Ste 110
Woodbury, MN 55125
Phone (651) 735-7414

6025 Lake Rd
Ste 200
Woodbury, MN 55125

2651 Hillcrest Dr
Ste 105
Hudson, WI 54016
Phone (715) 280-9151

Organizations & group practices 4

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.

Hospital & facility affiliations 35

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

View all 35

NPI Registry JSON

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

{
    "created_epoch": "1643414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643414400000",
    "number": "1104579242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "366 EL MATADOR TRL",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325066006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4724 N DAVIS HWY",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325032339",
            "telephone_number": "850-696-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUCKWORTH",
        "first_name": "CHRISTINA",
        "middle_name": "GRACE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-29",
        "last_updated": "2022-01-29",
        "certification_date": "2022-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pensacola, FL

Sources for this page

Verify at the official NPI Registry.