Individual provider Active NPI

Walter Dante Conwell, M.D.

  • Critical Care Medicine (Internal Medicine) Physician
  • Denver, CO
National Provider Identifier
1093977282
Registry record updated Nov 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Medicine (Internal Medicine) PhysicianTaxonomy code 207RC0200X
License
A159124 Issued in CA
Practice address
1375 E 20TH Ave
Denver, CO 80205-5422
Phone
(303) 338-4545
NPI assigned
Jun 28, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2019

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 51324 CO
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 51324 CO
Pulmonary Disease Physician 207RP1001X A159124 CA
Sleep Medicine (Internal Medicine) Physician 207RS0012X A159124 CA
Critical Care Medicine (Internal Medicine) Physician 207RC0200X A159124 CA Primary
Pulmonary Disease Physician 207RP1001X 51324 CO

Addresses

Primary practice location

1375 E 20TH Ave
Denver, CO 80205-5422

Mailing address

393 E Walnut St
PHR Group Provider Enrollment Unit 3Rd FL
Pasadena, CA 91188-0001
Phone (877) 608-0044

Other identifiers 2

IdentifierTypeStateIssuer
34877843MedicaidCO
027190OtherCOKAISER COMMERCIAL NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20250922002197 GA Practitioner - Sleep Medicine 6103018551 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Sleep Medicine
Education
Other, 2007
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

720 Westview Dr SW
Atlanta, GA 30310-1458

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A159124CAMDPulmonary Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Morehouse Medicine Inc. Internal Medicine CurrentSince Sep 1, 2025 Accepting new patients
Morehouse Healthcare, Inc. Internal Medicine CurrentSince Sep 1, 2025 Accepting new patients
Philippe G Lopez MD PC Critical Care Medicine PastSince Jun 16, 2024 Accepting new patients

Locations

720 Westview Dr SW
Atlanta, GA 30310
Phone (404) 756-1383

1513 Cleveland Ave
Bldg 500
East Point, GA 30344
Phone (404) 756-1204

Interoperability endpoints

  • Direct secure messaging: wconwell2945991@carolinashealthcaresystem.direct-ci.com

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1214611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572912000000",
    "number": "1093977282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "393 E WALNUT ST",
            "address_2": "PHR GROUP PROVIDER ENROLLMENT UNIT 3RD FL",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911880001",
            "telephone_number": "877-608-0044",
            "fax_number": "877-514-0903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1375 E 20TH AVE",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802055422",
            "telephone_number": "303-338-4545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONWELL",
        "first_name": "WALTER",
        "middle_name": "DANTE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-28",
        "last_updated": "2019-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CO",
            "license": "51324",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "CO",
            "license": "51324",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "CA",
            "license": "A159124",
            "primary": false
        },
        {
            "code": "207RS0012X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Sleep Medicine",
            "state": "CA",
            "license": "A159124",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "CA",
            "license": "A159124",
            "primary": true
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "CO",
            "license": "51324",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "34877843",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KAISER COMMERCIAL NUMBER",
            "identifier": "027190",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Denver, CO

Sources for this page

Verify at the official NPI Registry.