Charise Michde Mehrkens, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

10699 Issued in MN

Practice address

9855 Hospital Drive Suite 102 a
North Memorial Urgent Care Maple Grove
Maple Grove, MN 55369

Phone

(763) 581-9220

NPI assigned

Dec 30, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: cmehrkens88470@ehrdirect.mayoclinicmsg.org

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

{
    "created_epoch": "1262131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1381276800000",
    "number": "1851621635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3300 OAKDALE AVE N",
            "city": "ROBBINSDALE",
            "state": "MN",
            "postal_code": "554222926",
            "telephone_number": "763-581-9220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9855 HOSPITAL DRIVE SUITE 102 A",
            "address_2": "NORTH MEMORIAL URGENT CARE MAPLE GROVE",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "55369",
            "telephone_number": "763-581-9220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEHRKENS",
        "first_name": "CHARISE",
        "middle_name": "MICHDE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-12-30",
        "last_updated": "2013-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MN",
            "license": "1088601",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "10699",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Gregory S Mellesmoen, CRNA

• Physician Assistant in Maple Grove, MN
• Providers in Maple Grove, MN by specialty
• Physician Assistant in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2013; 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.