Individual provider Active NPI

Charles V Nye Jr., M.D.

  • Anesthesiology Physician
  • East Saint Louis, IL
National Provider Identifier
1225144348
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Practice address
129 N 8TH St
East Saint Louis, IL 62201-2917
Phone
(618) 482-7158
NPI assigned
Aug 22, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X IL Primary

Addresses

Primary practice location

129 N 8TH St
East Saint Louis, IL 62201-2917

Mailing address

388 N Ridge Rd
Columbia, IL 62236-1960
Phone (618) 558-3435

Other names 1

  • Charles V Nye Jr. Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20110715000348 MA Practitioner - AnesthesiologyPractitioner - Pain Management 7315834066 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
AnesthesiologyAlso: Pain Management
Education
Saint Louis University School of Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Prima Care, PCGroup PAC ID 2567356017, 222 clinicians

Practice addresses (Care Compare)

277 Pleasant St
Suite 240
Fall River, MA 02721-3005
Phone (508) 676-3292

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036097165ILMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Prima Care, PC CurrentSince May 1, 2025 Accepting new patients
Prima Care, PC CurrentSince May 1, 2025 Accepting new patients
Surgicenter Anesthesia Associates, LLC Anesthesiology CurrentSince Jun 1, 2011 Accepting new patients
Pamella S Gronemeyer Past Accepting new patients
SSM Health Care St. Louis Past Accepting new patients
Specialists in Anesthesia PC Anesthesiology Past Accepting new patients

Locations

272 Stanley St
Fall River, MA 02720
Phone (508) 672-2290

277 Pleasant St
Fl 4
Fall River, MA 02721
Phone 50867632921244

277 Pleasant St
Ste 240
Fall River, MA 02721
Phone (500) 300-3271

67 Slades Ferry Ave
Somerset, MA 02726
Phone (508) 673-9400

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1156204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1225144348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "388 N RIDGE RD",
            "city": "COLUMBIA",
            "state": "IL",
            "postal_code": "622361960",
            "telephone_number": "618-558-3435",
            "fax_number": "618-281-3435"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "129 N 8TH ST",
            "city": "EAST SAINT LOUIS",
            "state": "IL",
            "postal_code": "622012917",
            "telephone_number": "618-482-7158"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NYE",
        "first_name": "CHARLES",
        "middle_name": "V",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHARLES",
            "last_name": "NYE",
            "middle_name": "V",
            "suffix": "JR.",
            "credential": "M.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in East Saint Louis, IL

Sources for this page

Verify at the official NPI Registry.