Matthew Concannon LLC

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

R7H73 Issued in MO

Legal business name

MATTHEW CONCANNON LLC

Doing business as

Concannon Plastic Surgery

Practice address

3115 Falling Leaf CT
Columbia, MO 65201-3579

Phone

(573) 449-5000

Fax

(573) 449-5010

NPI assigned

May 9, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Matthew J Concannon, M.D.NPI 1366496515

Title

Owner

Phone

(573) 449-5000

Specialties & licenses 1

Addresses

Other names 1

• Concannon Plastic Surgery Doing business as

Locations

Practitioners 1

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.

• Matthew J Concannon, MD

  • Plastic and Reconstructive Surgery Physician
  • Columbia, MO
  • NPI 1366496515
  Authorized official Same address or phone

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

{
    "created_epoch": "1178668800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1134333487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3115 FALLING LEAF CT",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652013579",
            "telephone_number": "573-449-5000",
            "fax_number": "573-449-5010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3115 FALLING LEAF CT",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652013579",
            "telephone_number": "573-449-5000",
            "fax_number": "573-449-5010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MATTHEW CONCANNON LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-09",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CONCANNON",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "573-449-5000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": "MO",
            "license": "R7H73",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Concannon Plastic Surgery",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Matchstick LLC (DaVinci Dental Care)
• Delia A Matias I, M.D.
• Madison Matney, MA, PLPC
• Devin Matteoni, DO
• Michelle L Matteson-Kome, FNP/GNP
• Heather L Matthews, P.A.
• Kimberly M Matthews, APRN
• Charles F Mattingly, DDS
• Maryanne M Matzen, RD, LD
• Pamela Arlene Mauch, PHD

• Surgery Physician in Columbia, MO
• Providers in Columbia, MO by specialty
• Surgery Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.