NPIMap

Individual provider Active NPI

Charles Patrick Coyne III, M.D.

  • Family Medicine Physician
  • Warrenton, MO
National Provider Identifier
1295048031
Registry record updated Dec 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
201024955 Issued in MO
Practice address
521 Anwijo Way
Warrenton, MO 63383-1388
Phone
(636) 456-6103
Fax
(636) 456-6124
NPI assigned
Jul 22, 2010
Last updated
Dec 15, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 201024955 MO Primary

Addresses

Primary practice location

521 Anwijo Way
Warrenton, MO 63383-1388

Mailing address

521 Anwijo Way
Warrenton, MO 63383-1388
Phone (636) 456-6103

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131001000503 MO Practitioner - Family Practice 5991948689 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Clinic East CommunitiesGroup PAC ID 7214827922, shared by 6 NPIs, 573 clinicians
Aging Well Health Care, LLCGroup PAC ID 1153232038, 236 clinicians

Practice addresses (Care Compare)

1502 W Meyer Rd
Wentzville, MO 63385-3653
Phone (636) 698-6266

7212 Balson Ave
Saint Louis, MO 63130-3001

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 Medicine

State licenses

LicenseStateTypeSpecialty
201024955MOMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic East Communities Family Medicine CurrentSince Mar 11, 2020 Accepting new patients
Mercy Clinic East Communities Family Medicine CurrentSince Apr 1, 2019 Accepting new patients
Mercy Clinic East Communities Family Medicine CurrentSince Apr 1, 2019 Accepting new patients
Mercy Clinic Heart and Vascular, LLC Past Accepting new patients

Locations

621 S New Ballas Rd
Ste 189A
Saint Louis, MO 63141
Phone (314) 251-6335

621 S New Ballas Rd
Ste 4017B
Saint Louis, MO 63141
Phone (314) 872-9192

521 Anwijo Way
Warrenton, MO 63383
Phone (636) 239-7344

851 E 5th St
Ste 328
Washington, MO 63090
Phone (636) 239-1101

1502 W Meyer Rd
Wentzville, MO 63385
Phone (636) 698-6200

10 Wildcat Dr
Wright City, MO 63390
Phone (636) 791-9997

Interoperability endpoints

  • Direct secure messaging: ccoyne116584@directc.mercy.net

Organizations & group practices 5

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 9

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": "1279756800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765756800000",
    "number": "1295048031",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "521 ANWIJO WAY",
            "city": "WARRENTON",
            "state": "MO",
            "postal_code": "633831388",
            "telephone_number": "636-456-6103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "521 ANWIJO WAY",
            "city": "WARRENTON",
            "state": "MO",
            "postal_code": "633831388",
            "telephone_number": "636-456-6103",
            "fax_number": "636-456-6124"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COYNE",
        "first_name": "CHARLES",
        "middle_name": "PATRICK",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-07-22",
        "last_updated": "2025-12-15",
        "certification_date": "2025-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "201024955",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Warrenton, MO

Sources for this page

Verify at the official NPI Registry.