NPIMap

Organization Active NPI

Specialty Surgical Services

  • Surgery Physician
  • Columbia, MO
National Provider Identifier
1164545315
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
MDR7H73 Issued in MO
Legal business name
SPECIALTY SURGICAL SERVICES
Practice address
3115 Falling Leaf CT
Columbia, MO 65201-3579
Phone
(573) 449-5000
Fax
(573) 449-5010
NPI assigned
Apr 10, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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.
Title
Owner
Phone
(573) 449-5000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208600000X MDR7H73 MO Primary

Addresses

Primary practice location

3115 Falling Leaf CT
Columbia, MO 65201-3579

Mailing address

3115 Falling Leaf CT
Columbia, MO 65201-3579
Phone (573) 449-5000

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1176163200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1164545315",
    "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": "SPECIALTY SURGICAL SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-10",
        "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": "MDR7H73",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, MO

Sources for this page

  • 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.