Individual provider Active NPI

Matthew Philip Cormier, DO

  • Family Medicine Physician
  • Columbia, MO
National Provider Identifier
1831109347
Registry record updated Feb 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2000146084 Issued in MO
Practice address
900 W Nifong Blvd Ste 101
Columbia, MO 65203-4469
Phone
(573) 815-6640
Fax
(573) 815-6644
NPI assigned
Aug 8, 2006
Last updated
Feb 7, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 2000146084 MO Primary
Family Medicine Physician 207Q00000X 036101781 IL

Addresses

Primary practice location

900 W Nifong Blvd Ste 101
Columbia, MO 65203-4469

Mailing address

900 W Nifong Blvd Ste 101
Columbia, MO 65203-4469
Phone (573) 815-6640

Other practice location 1

326 N 24th St
Quincy, IL 62301-3140
Phone (217) 224-6423

Other identifiers 1

IdentifierTypeStateIssuer
244999512MedicaidMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, IL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20101130000780 MO Practitioner - Family Practice 6901092170 Reassigns benefits to 3 organizations
I20160907002145 IL Practitioner - Family Practice 6901092170

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
At Still University of Health Sciences, College of Osteo Med, Kirksville, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Boone Physician Services LLCGroup PAC ID 6507090644, 243 clinicians

Practice addresses (Care Compare)

900 W Nifong Blvd
Suite 101
Columbia, MO 65203-4469
Phone (573) 815-6640

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2000146084MOMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Scotland County Memorial Hospital Family Medicine Current Accepting new patients
Blessing Corporate Services Inc Family Medicine CurrentSince May 1, 2016 Accepting new patients
Scotland County Memorial Hospital Family Medicine CurrentSince Oct 4, 2010 Accepting new patients
Scotland County Memorial Hospital Family Medicine CurrentSince Oct 4, 2010 Accepting new patients
Boone Physician Services, LLC CurrentSince Feb 24, 2025 Accepting new patients
Scotland County Memorial Hospital Dba Wyaconda Medical Services Family Medicine Past Accepting new patients
Blessing Hospital Family Medicine Past Accepting new patients
Scotland County Memorial Hospital Family Medicine Past Accepting new patients
Blessing Hospital Past Accepting new patients
Physician Groups LC PastSince Feb 9, 2025 Accepting new patients
Scotland County Memorial Hosptial Past Accepting new patients

Locations

1005 Broadway St
Quincy, IL 62301

1600 E Broadway
Columbia, MO 65201
Phone (573) 632-5000

1705 E Broadway
Ste 280
Columbia, MO 65201
Phone (573) 815-7119

900 W Nifong Blvd
Ste 101
Columbia, MO 65203
Phone (573) 499-9009

450 E Sigler Ave
Ste A
Memphis, MO 63555
Phone (660) 465-2828

6996 County Road 326
Palmyra, MO 63461
Phone (573) 769-3710

Organizations & group practices 12

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 3

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": "1154995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738886400000",
    "number": "1831109347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 W NIFONG BLVD STE 101",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652034469",
            "telephone_number": "573-815-6640",
            "fax_number": "573-815-6644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 W NIFONG BLVD STE 101",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652034469",
            "telephone_number": "573-815-6640",
            "fax_number": "573-815-6644"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "326 N 24th St",
            "address_purpose": "LOCATION",
            "city": "Quincy",
            "state": "IL",
            "postal_code": "623013140",
            "country_code": "US",
            "telephone_number": "217-224-6423",
            "fax_number": "217-214-6299",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CORMIER",
        "first_name": "MATTHEW",
        "middle_name": "PHILIP",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-08",
        "last_updated": "2025-02-07",
        "certification_date": "2025-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "2000146084",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036101781",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "244999512",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, MO

Sources for this page

Verify at the official NPI Registry.