Mary Keough

Primary specialty

Sports Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081S0010X

License

PT03193 Issued in RI

Practice address

33 Veterans Memorial Pkwy
East Providence, RI 02914-5017

Phone

(401) 429-6290

NPI assigned

Aug 15, 2019

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

Enrolled in RI

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Matrix Sports Medicine & Physical Therapy Inc

  • Specialist
  • North Smithfield, RI
  • NPI 1205894532
  Medicare reassignment NPD

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

{
    "created_epoch": "1565827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785024000000",
    "number": "1235785239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 PLAINFIELD ST",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029094457",
            "telephone_number": "401-316-8344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33 VETERANS MEMORIAL PKWY",
            "city": "EAST PROVIDENCE",
            "state": "RI",
            "postal_code": "029145017",
            "telephone_number": "401-429-6290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEOUGH",
        "first_name": "MARY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-15",
        "last_updated": "2026-07-26",
        "certification_date": "2026-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2081S0010X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Sports Medicine",
            "state": "RI",
            "license": "PT03193",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Edward Francis Keenan, M.S.W.
• Kira Keenan, LCSW, MED
• Melissa Ann Kelly
• Steven Kempner, MD
• Leslie Kenney, NP
• Dania Khan
• Nicole Marie Kidd, LMHC
• Laurie R Kiely, LICSW
• Alice Yang-Hee Kim, M.D.
• Gary Steven Kishfy

• Sports Medicine (Physical Medicine & Rehabilitation) Physician in East Providence, RI
• Providers in East Providence, RI by specialty
• Sports Medicine (Physical Medicine & Rehabilitation) Physician in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.