Individual provider Active NPI

Keith L Callahan, M.D.

  • Family Medicine Physician
  • Warwick, RI
National Provider Identifier
1629063219
Registry record updated Aug 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD12303 Issued in RI
Practice address
390 Toll Gate Rd
Suite 108
Warwick, RI 02886-4326
Phone
(401) 921-5672
Fax
(401) 921-5679
NPI assigned
Sep 20, 2005
Last updated
Aug 14, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD12303 RI Primary

Addresses

Primary practice location

390 Toll Gate Rd
Suite 108
Warwick, RI 02886-4326

Mailing address

390 Toll Gate Rd
Suite 108
Warwick, RI 02886-4326
Phone (401) 921-5672

Other practice location 1

1199 Reservoir Ave
Cranston, RI 02920-6008
Phone (401) 382-4580

Other practice location 2

2220 Plainfield Pike
Cranston, RI 02921-2031
Phone (401) 585-8500

Other identifiers 6

IdentifierTypeStateIssuer
414283OtherRIBLUE CHIP
32250-6OtherRIBLUE CROSS
810900591OtherRIMULTIPLAN/PHCS
9201212OtherRICIGNA
496-667OtherRITUFTS
AA98861OtherRIHARVARD PILGRIM

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071024000216 RI Practitioner - Family Practice 6608806047 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Rush Medical College of Rush University, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Keith L. Callahan M.D., P.C.Group PAC ID 3779670666, 3 clinicians

Practice addresses (Care Compare)

390 Toll Gate Rd
Suite 108
Warwick, RI 02886-4326
Phone (401) 921-5672

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD12303RIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Keith L. Callahan M.D., P.C. CurrentSince Aug 1, 2007 Accepting new patients
Copley Memorial Hospital Inc. Family Medicine Past Accepting new patients

Locations

390 Toll Gate Rd
Ste 108
Warwick, RI 02886
Phone (401) 739-7210

470 Toll Gate Rd
Ste 103
Warwick, RI 02886
Phone (401) 921-5672

Interoperability endpoints

  • Direct secure messaging: kcallahan@direct.carene.org

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1127174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786665600000",
    "number": "1629063219",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "390 TOLL GATE RD",
            "address_2": "SUITE 108",
            "city": "WARWICK",
            "state": "RI",
            "postal_code": "028864326",
            "telephone_number": "401-921-5672",
            "fax_number": "401-921-5679"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "390 TOLL GATE RD",
            "address_2": "SUITE 108",
            "city": "WARWICK",
            "state": "RI",
            "postal_code": "028864326",
            "telephone_number": "401-921-5672",
            "fax_number": "401-921-5679"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1199 Reservoir Ave",
            "address_purpose": "LOCATION",
            "city": "Cranston",
            "state": "RI",
            "postal_code": "029206008",
            "country_code": "US",
            "telephone_number": "401-382-4580",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2220 Plainfield Pike",
            "address_purpose": "LOCATION",
            "city": "Cranston",
            "state": "RI",
            "postal_code": "029212031",
            "country_code": "US",
            "telephone_number": "401-585-8500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CALLAHAN",
        "first_name": "KEITH",
        "middle_name": "L",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-20",
        "last_updated": "2026-08-14",
        "certification_date": "2026-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "RI",
            "license": "MD12303",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CHIP",
            "identifier": "414283",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "32250-6",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MULTIPLAN/PHCS",
            "identifier": "810900591",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "9201212",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS",
            "identifier": "496-667",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD PILGRIM",
            "identifier": "AA98861",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Warwick, RI

Sources for this page

Verify at the official NPI Registry.