Provider Demographics
NPI:1851305148
Name:SALYERS-CARROLL, KERI JEANNINE (PT)
Entity Type:Individual
Prefix:MRS
First Name:KERI
Middle Name:JEANNINE
Last Name:SALYERS-CARROLL
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MS
Other - First Name:KERI
Other - Middle Name:JEANNINE
Other - Last Name:SALYERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:2003 PHILLIPS TER UNIT 6
Mailing Address - Street 2:
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21401-8169
Mailing Address - Country:US
Mailing Address - Phone:410-956-1574
Mailing Address - Fax:
Practice Address - Street 1:3179 BRAVERTON ST
Practice Address - Street 2:SUITE 201
Practice Address - City:EDGEWATER
Practice Address - State:MD
Practice Address - Zip Code:21037-2665
Practice Address - Country:US
Practice Address - Phone:410-956-4308
Practice Address - Fax:410-956-8038
Is Sole Proprietor?:No
Enumeration Date:2006-07-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD20348225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD57731OtherJOHN HOPKINS HEALTHCARE
MD5622033OtherCCN NETWORK
MD699023OtherNCPPO
MDT6710017OtherBLUECROSS BLUESHIELD DC
MD2431568OtherUNITED HEALTHCARE
MD756LL185OtherRAILROAD MEDICARE
MD619225-02OtherBLUECROSS BLUESHIELD MD
MDT6710017OtherBLUECROSS BLUESHIELD DC
MD756LL185Medicare ID - Type Unspecified