Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Kellen James Cameron, DPT

Individual provider Physical Therapist · NPI 1164144002

Kellen James Cameron, DPT is a Physical Therapist in Private Practice in Maple Grove, Minnesota. Qualified in 2022, 4 years ago. Practices with Interventional Spine and Pain Physicians PA, a 43-clinician group and accepts Medicare assignment. Licensed in Minnesota.

Years since qualifying
4
Licensed in
MN
In the registry since
2022
What do these letters mean?
DPT — Doctor of Physical Therapy
The doctoral degree now required to enter physical therapy practice.

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Practice location Address checks out

7767 Elm Creek Blvd N Ste 160
Maple Grove, MN 55369-7078
Phone: (763) 201-8191
Fax: (763) 201-8192
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence 12872 (MN)

Record details

NPI number1164144002
Entity typeIndividual (Type 1)
GenderMale
Credentials DPT
Sole proprietorYes
NPI enumeratedSeptember 16, 2022
Last updated in NPPESSeptember 16, 2022
Certification dateSeptember 16, 2022
Mailing address9645 Grove Cir N Ste 200, Maple Grove, MN 55369-2684

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice Interventional Spine And Pain Physicians Pa — 43 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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