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MRS. KELLI KATHARINA ELLENBAUM MS, CCC-SLP
NPI 1003934878
Speech-Language Pathologist in Bismarck, ND

Active since March 27, 2007
2625 N 19TH ST, BISMARCK, ND 58503(701) 222-3175(701) 222-3186 Get Directions Write a Review

NPPES record last updated: March 15, 2021. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Mar 15, 2021, Mar 19, 2018, Jul 13, 2016 (3 updates tracked since 2016).

About Mrs. Kelli Katharina Ellenbaum Ms, Ccc-slp NPPES

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

MRS. KELLI KATHARINA ELLENBAUM MS, CCC-SLP (NPI 1003934878) is an individual speech-language pathologist provider in Bismarck, North Dakota, licensed in North Dakota (862) and active in the NPI registry since March 2007.

NPPES Registry Identity

NPI1003934878
Entity TypeIndividualFemale
Primary Taxonomy235Z00000X
Provider Legal NameMRS. KELLI KATHARINA ELLENBAUMCredential: MS, CCC-SLP
Location Address2625 N 19TH STBismarck, ND 58503-0574
Mailing Address2625 N 19th StBismarck, ND 58503-0574 · (701) 222-3175 · Fax (701) 222-3186
Phone(701) 222-3175
Fax(701) 222-3186
Sole ProprietorNo
Enumeration DateMarch 27, 2007
Last NPPES UpdateMarch 15, 20213 updates tracked since enumeration
NPPES CertifiedMarch 15, 2021
✔ NPI 1003934878 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpeech-Language PathologistSpeech, Language and Hearing Service Providers
Taxonomy Code235Z00000X
License✔ Licensed in ND · 862
Definition
The speech-language pathologist is the professional who engages in clinical services, prevention, advocacy, education, administration, and research in the areas of communication and swallowing across the life span from infancy through geriatrics. Speech-language pathologists address typical and atypical impairments and disorders related to communication and swallowing in the areas of speech sound production, resonance, voice, fluency, language (comprehension and expression), cognition, and feeding and swallowing.
2625 N 19TH ST, Bismarck, ND 58503
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Other Identifiers 3

Medicaid54627ND
Other27424ND · Bcbs Nd Provider Number
Medicaid1454835ND

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross Blue Shield of North Dakota, Sanford Health Plan.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mrs. Kelli Katharina Ellenbaum Ms, Ccc-slp is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Billing Reassignment

Medicare enrollment records show Kelli Ellenbaum reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Red Door Pediatric Therapy, Inc
Same address
Speech-Language Pathologist
2625 N 19TH ST
Bismarck, ND 58503
  • Reassigned Medicare billing, North Dakota enrollment
  • 30 clinicians in this Medicare group
NPI 1639257033 (701) 222-3175

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

LINAYA MING MS, CCC-SLP
Speech-Language Pathologist
2625 N 19TH ST
BISMARCK, ND 58503
Burleigh County (701) 222-3175
MADISON LAUREN BRAZEEL MS, CCC-SLP
Speech-Language Pathologist
2625 N 19TH ST
BISMARCK, ND 58503
Burleigh County (701) 222-3175
HAYLE LYNN HAUSER MS, OTR/L
Occupational Therapist
2625 N 19TH ST
BISMARCK, ND 58503
Burleigh County (701) 222-3175
MADISON LEE JORGENSON SLP
Speech-Language Pathologist
2625 N 19TH ST
BISMARCK, ND 58503
Burleigh County (701) 222-3175
MRS. SARA ERICKSON MS, OTR/L
Occupational Therapist
2625 N 19TH ST
BISMARCK, ND 58503
Burleigh County (701) 222-3175
COURTNEY KRAFT MS, OTR/L
Occupational Therapist
2625 N 19TH ST
BISMARCK, ND 58503
Burleigh County (701) 222-3175
TAYLOR SAILER DPT
Physical Therapist
2625 N 19TH ST
BISMARCK, ND 58503
Burleigh County (701) 222-3175
JILL DWORSHAK MS, OTR/L
Occupational Therapist
2625 N 19TH ST
BISMARCK, ND 58503
Burleigh County (701) 222-3175

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 Kelli Ellenbaum's NPI number?

The NPI number for Kelli Ellenbaum is 1003934878. It was assigned to this individual provider in the NPPES registry on March 27, 2007.

Where is Kelli Ellenbaum located?

Kelli Ellenbaum practices at 2625 N 19th St, Bismarck, ND 58503. The listed phone number is (701) 222-3175.

What is Kelli Ellenbaum's specialty?

The primary specialty registered for this NPI is Speech-Language Pathologist with taxonomy code 235Z00000X.

Is Kelli Ellenbaum enrolled in Medicare?

Yes. Kelli Ellenbaum is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Kelli Ellenbaum's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Kelli Ellenbaum reassigns Medicare benefits to Red Door Pediatric Therapy, Inc (Bismarck, ND). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Kelli Ellenbaum's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Kelli Ellenbaum accept?

Health plans from Blue Cross Blue Shield of North Dakota and Sanford Health Plan list Kelli Ellenbaum as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Kelli Ellenbaum was last updated on March 15, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.