Individual provider Active NPI

Cameron Ellis

  • Speech-Language Pathologist
  • Eagan, MN
National Provider Identifier
1194601807
Registry record updated Aug 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Practice address
2795 Pilot Knob Rd Ste 100
Eagan, MN 55121-1930
Phone
(651) 994-9644
NPI assigned
Aug 15, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X MN Primary

Addresses

Primary practice location

2795 Pilot Knob Rd Ste 100
Eagan, MN 55121-1930

Mailing address

2795 Pilot Knob Rd Ste 100
Eagan, MN 55121-1930
Phone (651) 994-9644

Other practice location 1

14635 Pennock Ave Ste 300
Apple Valley, MN 55124-6588
Phone (651) 994-9644

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2795 Pilot Knob Rd
Suite 100
Eagan, MN 55121-1176

2795 Pilot Knob Rd
Suite 100
Eagan, MN 55121-1930

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Children'S Therapy Center, Inc Speech-Language Pathologist CurrentSince Jun 1, 2026 Accepting new patients
Children'S Therapy Ctr, Inc Speech-Language Pathologist PastSince Jun 1, 2026 Accepting new patients

Locations

14635 Pennock Ave
Ste 300
Apple Valley, MN 55124
Phone (651) 994-9644

2795 Pilot Knob Rd
Ste 100
Saint Paul, MN 55121
Phone (651) 994-9644

Organizations & group practices 2

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": "1755216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755216000000",
    "number": "1194601807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2795 PILOT KNOB RD STE 100",
            "city": "EAGAN",
            "state": "MN",
            "postal_code": "551211930",
            "telephone_number": "651-994-9644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2795 PILOT KNOB RD STE 100",
            "city": "EAGAN",
            "state": "MN",
            "postal_code": "551211930",
            "telephone_number": "651-994-9644"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14635 Pennock Ave Ste 300",
            "address_purpose": "LOCATION",
            "city": "Apple Valley",
            "state": "MN",
            "postal_code": "551246588",
            "country_code": "US",
            "telephone_number": "651-994-9644",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "CAMERON",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-08-15",
        "last_updated": "2025-08-15",
        "certification_date": "2025-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eagan, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.