Matthew J Concannon, MD

Primary specialty

Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X

License

MDR7H73 Issued in MO

Practice address

3115 Falling Leaf CT
Columbia, MO 65201-3579

Phone

(573) 449-5000

Fax

(573) 449-5010

NPI assigned

May 20, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/IFGEDD/Endpoint/IFGEDD

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.

• Institute for Outpatient Surgery, LLC

  • Ambulatory Surgical Clinic/Center
  • Columbia, MO
  • NPI 1477546687
  NPD (past)
• Ozarks Medical Center

  • General Acute Care Hospital
  • West Plains, MO
  • NPI 1831115641
  NPD (past)

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

{
    "created_epoch": "1148083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1366496515",
    "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": {
        "last_name": "CONCANNON",
        "first_name": "MATTHEW",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "MO",
            "license": "MDR7H73",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHLINK",
            "identifier": "289606",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALCARE",
            "identifier": "1304006",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CHOICE",
            "identifier": "31925",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "31925",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Compass Health, Inc.
• Compass Health, Inc.
• Compass Therapy Solutions
• Compassus HH of Missouri I, LLC
• Comprehensive Human Services
• Samantha Lauren Conde, MD
• Lydia Conlay, MD
• Erika Louise Conley, RD
• Angela Connell, M.P.T.
• Kirsten Diane Connell, DNP, APRN, FNP-BC

• All providers in Columbia, MO
• Plastic and Reconstructive Surgery Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.