Carolyn Elaine Russell-Canaan, D.P.T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

23328 Issued in MD

Practice address

516 N Rolling Rd
Ste 302
Catonsville, MD 21228-4140

Phone

(410) 744-1666

Fax

(410) 788-9755

NPI assigned

Jul 8, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1278547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1494374400000",
    "number": "1578875563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3179 BRAVERTON ST",
            "address_2": "STE 201",
            "city": "EDGEWATER",
            "state": "MD",
            "postal_code": "210372667",
            "telephone_number": "800-793-5464",
            "fax_number": "267-321-2099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "516 N ROLLING RD",
            "address_2": "STE 302",
            "city": "CATONSVILLE",
            "state": "MD",
            "postal_code": "212284140",
            "telephone_number": "410-744-1666",
            "fax_number": "410-788-9755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL-CANAAN",
        "first_name": "CAROLYN",
        "middle_name": "ELAINE",
        "credential": "D.P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-08",
        "last_updated": "2017-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "23328",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapist in Catonsville, MD
• Providers in Catonsville, MD by specialty
• Physical Therapist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2017; 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.