Charles Glen Mickelson, C.PED.
NPI 1568773679ActiveIndividual· Pedorthist· South St. Paul,, MN
Pedorthist (C.PED.) in South St. Paul,, Minnesota, with an NPI issued in June 2010.
Overview
| NPI | 1568773679 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | C.PED. |
| Sole proprietor | Yes |
| NPI issued | Jun 24, 2010 |
| Last updated in NPPES | Nov 9, 2010 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Pedorthist Primary | 224L00000X | — | MN |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|