Individual provider Active NPI

Warren Conway, MD

  • Family Medicine Physician
  • San Angelo, TX
National Provider Identifier
1245290717
Registry record updated Dec 5, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
K1993 Issued in TX
Practice address
3605 Executive Dr
San Angelo, TX 76904
Phone
(325) 949-9555
NPI assigned
Mar 27, 2006
Last updated
Dec 5, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2018

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 K1993 TX Primary

Addresses

Primary practice location

3605 Executive Dr
San Angelo, TX 76904

Mailing address

3605 Executive Dr
San Angelo, TX 76904-6884
Phone (325) 949-9555

Other practice location 1

3555 Knickerbocker Rd
San Angelo, TX 76904
Phone (325) 224-5850

Other practice location 2

3555 Knickerbocker Rd
San Angelo, TX 76904-7610
Phone (325) 224-5850

Other identifiers 2

IdentifierTypeStateIssuer
81660SOtherTXBLUE CROSS
042391501MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20091125000429 TX Practitioner - Family Practice 6800935172 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Texas a & M University System, HSC, College of Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Shannon ClinicGroup PAC ID 0840103727, 550 clinicians
The West Texas Rehabilitation CenterGroup PAC ID 2860301215, shared by 5 NPIs, 444 clinicians

Practice addresses (Care Compare)

120 E Beauregard Ave
San Angelo, TX 76903-5919
Phone (325) 747-1511

120 E Harris Ave
San Angelo, TX 76903-5904
Phone (325) 747-6741

131 E Beauregard Ave
San Angelo, TX 76903-5918
Phone (325) 747-2025

2142 Sunset Dr
San Angelo, TX 76904-6829
Phone (325) 747-1511

220 E Harris Ave
San Angelo, TX 76903-5906
Phone (325) 747-1511

2626 N Bryant Blvd
San Angelo, TX 76903-2861
Phone (325) 747-1511

3501 Knickerbocker Rd
San Angelo, TX 76904-7610
Phone (325) 747-7500

3502 Knickerbocker Rd
San Angelo, TX 76904-7671
Phone (325) 747-2222

3555 Knickerbocker Rd
San Angelo, TX 76904-7610
Phone (325) 747-1511

4235 Southwest Blvd
San Angelo, TX 76904-5635
Phone (325) 747-1511

4251 Sunset Dr
San Angelo, TX 76904-5653
Phone (325) 747-2226

4601 Hartford St
Abilene, TX 79605-4603
Phone (325) 793-3411

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
82.63 of 100Reported as group
Quality
78.21
Promoting interoperability
96
Improvement activities
40
Cost
67.22

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Shannon Clinic Family Medicine CurrentSince Mar 1, 2021 Accepting new patients

Locations

120 E Beauregard Ave
San Angelo, TX 76903
Phone (915) 658-1511

3555 Knickerbocker Rd
San Angelo, TX 76904
Phone (325) 224-5411

3605 Executive Dr
San Angelo, TX 76904
Phone (325) 949-9555

Interoperability endpoints

  • Direct secure messaging: cwarren37892@shannonhealth.direct-ci.com

Organizations & group practices 1

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 8

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": "1143417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543968000000",
    "number": "1245290717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3605 EXECUTIVE DR",
            "city": "SAN ANGELO",
            "state": "TX",
            "postal_code": "769046884",
            "telephone_number": "325-949-9555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3605 EXECUTIVE DR",
            "city": "SAN ANGELO",
            "state": "TX",
            "postal_code": "76904",
            "telephone_number": "325-949-9555"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3555 Knickerbocker Rd",
            "address_purpose": "LOCATION",
            "city": "San Angelo",
            "state": "TX",
            "postal_code": "76904",
            "country_code": "US",
            "telephone_number": "325-224-5850",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3555 Knickerbocker Rd",
            "address_purpose": "LOCATION",
            "city": "San Angelo",
            "state": "TX",
            "postal_code": "769047610",
            "country_code": "US",
            "telephone_number": "325-224-5850",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CONWAY",
        "first_name": "WARREN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-27",
        "last_updated": "2018-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "K1993",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "81660S",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "042391501",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Angelo, TX

Sources for this page

Verify at the official NPI Registry.