Individual provider Active NPI

Gretta Jane Hughes, PA-C, MPH

  • Physician Assistant
  • Minneapolis, MN
National Provider Identifier
1255512331
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
11995 Issued in MN
Practice address
250 S 4TH St
Minneapolis, MN 55415-1321
Phone
(218) 340-5044
NPI assigned
Nov 17, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA030513 DC
Physician Assistant 363A00000X 0110002648 VA
Physician Assistant 363A00000X 11995 MN Primary

Addresses

Primary practice location

250 S 4TH St
Minneapolis, MN 55415-1321

Mailing address

250 S 4TH St
Minneapolis, MN 55415-1321
Phone (612) 673-5305

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)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA030513DCMDPhysician Assistant
11995MNMDPhysician Assistant
0110002468VAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
City of Minneapolis Past Accepting new patients

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": "1195257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1255512331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 S 4TH ST",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554151321",
            "telephone_number": "612-673-5305",
            "fax_number": "612-673-3866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 S 4TH ST",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554151321",
            "telephone_number": "218-340-5044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUGHES",
        "first_name": "GRETTA",
        "middle_name": "JANE",
        "credential": "PA-C, MPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-11-17",
        "last_updated": "2022-07-21",
        "certification_date": "2021-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "DC",
            "license": "PA030513",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110002648",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "11995",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.