NPIMap

Organization Active NPI

Kent County Memorial Hospital

  • General Acute Care Hospital
  • Warwick, RI
National Provider Identifier
1386643294
Registry record updated Oct 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
License
HOS00125 Issued in RI
Legal business name
KENT COUNTY MEMORIAL HOSPITAL
Practice address
455 Toll Gate Rd
Warwick, RI 02886-2759
Phone
(401) 737-7010
Fax
(401) 736-1000
NPI assigned
Jul 21, 2005
Last updated
Oct 7, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2026

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

Authorized official

Name
Todd Alan Conklin
Title
Evp Chief Financial Officer
Phone
(401) 737-7010

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X
Pulmonary Disease Physician 207RP1001X
Clinical Pathology/Laboratory Medicine Physician 207ZP0105X
Neurology Physician 2084N0400X
Vascular Surgery Physician 2086S0129X
General Acute Care Hospital 282N00000X HOS00125 RI Primary
Substance Abuse Rehabilitation Facility 324500000X

Addresses

Primary practice location

455 Toll Gate Rd
Warwick, RI 02886-2759

Mailing address

455 Toll Gate Rd
Warwick, RI 02886-2759
Phone (401) 737-7010

Other identifiers 14

IdentifierTypeStateIssuer
000000001935OtherRIKENT COUNTY MEMORIAL HOSP
4100009MedicaidRI
0000006181OtherRIKENT COUNTY PHYS PATH
5000154OtherRIKENT COUNTY MEMORIAL HOSP
5000152OtherRIKENT COUNTY MEMORIAL HOSP
DD3248OtherKENT COUNTY HOSPITAL
0000006109OtherRIKENT COUNTY PHYS VASC
0000006110OtherRIKENT COUNTY PHYS EEG
0000006111OtherRIKENT COUNTY PHYS EKG
709006109OtherRIKENT COUNTY PHYS VASC
900247OtherRIKENT COUNTY MEMORIAL HOSP
0000000021OtherRIKENT COUNTY MEMORIAL HOSP
0000006112OtherRIKENT COUNTY PHYS PULM
OP00009MedicaidRI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071201000206 RI Part A Provider - Hospital 2668377078 1 other NPI on this enrollment
Practice locations: Cranston, RI; Warwick, RI; Providence, RI; Pawtucket, RI; East Greenwich, RI

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1386643294. Details of each certification follow.

Hospital certification: CCN 410009

Legal name
KENT COUNTY MEMORIAL HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
Mar 29, 2016
Beds
359
Ownership / control type
Private (for profit)
Organization structure
CorporationNon-profit
Incorporated
Apr 25, 1946 in RI
Enrollment address
455 Toll Gate Rd
Warwick, RI 28862759
Main/Primary Hospital Location
Hospital subgroups
Acute care, Rehabilitation, Rehabilitation unit

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Care Compare: Hospital

Medicare Care Compare
Listed as
Kent County Memorial HospitalCCN 410009 · All quality measures
Overall star rating
3 of 5
Type
Acute Care Hospitals
Ownership
Proprietary
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory

Locations

59 South County Commons Way
Unit 2
Wakefield, RI 02879

215 Toll Gate Rd
Warwick, RI 02886
Phone (401) 738-3100

Ownership & related parties

All disclosed owners & managing parties 24

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Andrew Edward Burke Individual W-2 Managing EmployeeFinance Jan 1, 2024
Ana Fulton Individual Corporate Director Dec 16, 2021
Ashley Taylor Individual Corporate OfficerGeneral Counsel/Officer/Ast Secreta Jan 1, 2025
R Stephen Manty Individual Corporate OfficerVice Chair & Treasurer Jan 1, 2020
Edward J Cooney Individual Corporate DirectorDirector/Board Jan 1, 2025
Michael E Wagner Individual Corporate OfficerOfficer Ceo Jan 1, 2024
Methodius G Tuuli Individual Corporate DirectorDirector/Board Jan 1, 2025
Joy K Cave Individual Corporate DirectorDirector/Board Jan 1, 2026
Care New England Health Systems Organization, Providence, RI Holding company Operational/Managerial Control Feb 1, 1996 100%
James Michael Burke Individual Corporate Officer Oct 1, 2015
W-2 Managing EmployeeVP of Finance, Med/Surg Hospitals Oct 1, 2015
Kevin E Baill Individual Corporate Director Jan 16, 2019
James a Ruggieri Individual Corporate DirectorDirector/Board Jan 1, 2026
Krysten Mary Blanchette Individual Contracted Managing Employee Jan 1, 2015
Sharon Conard-Wells Individual Corporate Director Apr 23, 2015
Carolynn Masters Individual Corporate DirectorDirector Jan 1, 2024
Dawn Lynn Rodgers Individual W-2 Managing EmployeeCredentialing Oct 15, 2018
Gary E Furtado Individual Corporate OfficerChairperson Oct 1, 2013
James a Botvin Individual Corporate DirectorSecretary Jan 1, 2015
Heather Rose Mattias Individual W-2 Managing EmployeeContracting Jan 1, 2024
Patrick J Murray Individual Corporate Director Oct 1, 2013
Lisa Marie Colombo Individual Corporate DirectorDirector/Board Jan 1, 2026
Peter R Phillips Individual Corporate DirectorDirector Jan 1, 2024
Judith Remondi Individual Corporate Director Nov 1, 2020
Todd a Conklin Individual Corporate DirectorDirector Jan 1, 2024
W-2 Managing EmployeeChief Financial Officer Jan 1, 2024

Owners & managing parties with NPI records 4

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 5

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Practitioners 65

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 65

Affiliated clinicians 953

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 953

NPI Registry JSON

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

{
    "created_epoch": "1121904000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1791331200000",
    "number": "1386643294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "455 TOLL GATE RD",
            "city": "WARWICK",
            "state": "RI",
            "postal_code": "028862759",
            "telephone_number": "401-737-7010",
            "fax_number": "401-736-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "455 TOLL GATE RD",
            "city": "WARWICK",
            "state": "RI",
            "postal_code": "028862759",
            "telephone_number": "401-737-7010",
            "fax_number": "401-736-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENT COUNTY MEMORIAL HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-21",
        "last_updated": "2026-10-07",
        "certification_date": "2026-10-07",
        "status": "A",
        "authorized_official_last_name": "CONKLIN",
        "authorized_official_first_name": "TODD",
        "authorized_official_middle_name": "ALAN",
        "authorized_official_title_or_position": "EVP CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "401-737-7010"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207ZP0105X",
            "taxonomy_group": "",
            "desc": "Pathology, Clinical Pathology/Laboratory Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "RI",
            "license": "HOS00125",
            "primary": true
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KENT COUNTY MEMORIAL HOSP",
            "identifier": "000000001935",
            "state": "RI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4100009",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KENT COUNTY PHYS PATH",
            "identifier": "0000006181",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KENT COUNTY MEMORIAL HOSP",
            "identifier": "5000154",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KENT COUNTY MEMORIAL HOSP",
            "identifier": "5000152",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KENT COUNTY HOSPITAL",
            "identifier": "DD3248",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KENT COUNTY PHYS VASC",
            "identifier": "0000006109",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KENT COUNTY PHYS EEG",
            "identifier": "0000006110",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KENT COUNTY PHYS EKG",
            "identifier": "0000006111",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KENT COUNTY PHYS VASC",
            "identifier": "709006109",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KENT COUNTY MEMORIAL HOSP",
            "identifier": "900247",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KENT COUNTY MEMORIAL HOSP",
            "identifier": "0000000021",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KENT COUNTY PHYS PULM",
            "identifier": "0000006112",
            "state": "RI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "OP00009",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Warwick, RI

Sources for this page

Verify at the official NPI Registry.