MR. CHARLES GLEN MICKELSON C.PED.
NPI 1568773679
Pedorthist in South St. Paul,, MN

Q: What is Charles Mickelson's NPI number?

The NPI number for Charles Mickelson is 1568773679. It was assigned to this individual provider in the NPPES registry on June 24, 2010.

Q: What is Charles Mickelson's specialty?

The primary specialty registered for this NPI is Pedorthist with taxonomy code 224L00000X.

Q: When was this NPI record last updated?

The NPPES record for Charles Mickelson was last updated on November 9, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since June 24, 2010

423 12TH AVE. NORTH, SOUTH ST. PAUL,, MN 55075(651) 291-7000 Get Directions Write a Review

NPPES record last updated: November 9, 2010. Verified against the NPPES registry weekly; last sync: August 30, 2026.

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About Mr. Charles Glen Mickelson C.ped. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MR. CHARLES GLEN MICKELSON C.PED. (NPI 1568773679) is an individual pedorthist provider in South St. Paul,, Minnesota and active in the NPI registry since June 2010.

NPPES Registry Identity

NPI1568773679

Entity TypeIndividualMale

Primary Taxonomy224L00000X

Provider Legal NameMR. CHARLES GLEN MICKELSONCredential: C.PED.

Location Address423 12TH AVE. NORTHSouth St. Paul,, MN 55075-1915

Mailing Address423 12th Ave. NorthSouth St. Paul,, MN 55075-1915 · (651) 291-7000

Phone(651) 291-7000

Sole ProprietorYes

Enumeration DateJune 24, 2010

Last NPPES UpdateNovember 9, 2010

✔ NPI 1568773679 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPedorthistRespiratory, Developmental, Rehabilitative and Restorative Service Providers

Taxonomy Code224L00000X

Definition

An individual who is trained in the management and treatment of conditions of the foot, ankle, and lower extremities requiring fitting, fabricating, and adjusting of pedorthic devices.

423 12TH AVE. NORTH, South St. Paul,, MN 55075

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Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Charles Mickelson's NPI number?

The NPI number for Charles Mickelson is 1568773679. It was assigned to this individual provider in the NPPES registry on June 24, 2010.

Where is Charles Mickelson located?

Charles Mickelson practices at 423 12th Ave. North, South St. Paul,, MN 55075. The listed phone number is (651) 291-7000.

What is Charles Mickelson's specialty?

The primary specialty registered for this NPI is Pedorthist with taxonomy code 224L00000X.

When was this NPI record last updated?

The NPPES record for Charles Mickelson was last updated on November 9, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.