OrganizationActive
Specialty Surgical Services
NPI 1164545315 · Surgery Physician · Columbia, MO
Provider details
- NPI number
- 1164545315
- Entity type
- Organization
- Primary specialty
- Surgery PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Matthew Concannon, Owner(573) 449-5000
- License
- MDR7H73 (MO)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
Detailed profile(89/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
3115 Falling Leaf Ct
Columbia, MO 65201-3579
Phone: (573) 449-5000
Fax: (573) 449-5010
Street-level locationGet directions
Mailing address
3115 Falling Leaf Ct
Columbia, MO 65201-3579
Registry dates
- Enumerated
- 2007-04-10
- Last updated
- 2020-08-22
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.