NPIMap

Individual provider Active NPI

Olusegun Adebayo Coker, M.D.

  • Family Medicine Physician
  • Saint Louis, MO
National Provider Identifier
1295998748
Registry record updated Jun 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2026003856 Issued in MO
Practice address
3009 N. Ballas Rd
Suite 226a
Saint Louis, MO 63131
Phone
(314) 996-4900
Fax
(314) 996-4901
NPI assigned
Jul 4, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2026

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 2026003856 MO Primary

Addresses

Primary practice location

3009 N. Ballas Rd
Suite 226a
Saint Louis, MO 63131

Mailing address

3009 N. Ballas Rd
Suite 226a
Saint Louis, MO 63131
Phone (314) 996-4900

Other names 1

  • Dr. Adebayo Olusegun Coker Other name

Electronic endpoints 1

TypeEndpointUseAffiliation
FHIR URL https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ Health Information Exchange (HIE)

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
I20260623003094 MO Practitioner - Family Practice 6103095922 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Meharry Medical College School of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Physician Groups LCGroup PAC ID 3072421254, 526 clinicians

Practice addresses (Care Compare)

2630 Hwy K
O Fallon, MO 63368-6624
Phone (636) 240-5454

3009 N Ballas Rd
Suite 227a
Saint Louis, MO 63131-2308
Phone (314) 996-7800

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
036.128162ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Fairview Heights Medical Group SC CurrentSince Aug 1, 2011 Accepting new patients
Fairview Heights Medical Group SC CurrentSince Aug 1, 2011 Accepting new patients
Ozarks Medical Center Family Medicine Past Accepting new patients
Physician Groups LC Family Medicine Past Accepting new patients
Physician Groups LC Past Accepting new patients

Locations

1 Memorial Dr
Alton, IL 62002
Phone (618) 463-7240

4 Memorial Dr
Ste 230
Alton, IL 62002
Phone (618) 463-7874

4 Memorial Dr
Ste 230B
Alton, IL 62002
Phone (618) 463-7874

4 Memorial Dr
#230B
Alton, IL 62002
Phone (314) 953-6093

1095 Belt Line Rd
Ste 500
Collinsville, IL 62234
Phone (618) 343-6005

2122 Troy Rd
Ste 130
Edwardsville, IL 62025
Phone (618) 692-9876

670 Mason Ridge Center Dr
Ste 300
Saint Louis, MO 63141
Phone (314) 953-8250

660 Mason Ridge Center Dr
Saint Louis, MO 63141
Phone (314) 273-6433

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 and National Provider Directory roles.

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": "1215129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780963200000",
    "number": "1295998748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3009 N. BALLAS RD",
            "address_2": "SUITE 226A",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "63131",
            "telephone_number": "314-996-4900",
            "fax_number": "314-996-4901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3009 N. BALLAS RD",
            "address_2": "SUITE 226A",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "63131",
            "telephone_number": "314-996-4900",
            "fax_number": "314-996-4901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COKER",
        "first_name": "OLUSEGUN",
        "middle_name": "ADEBAYO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-04",
        "last_updated": "2026-06-09",
        "certification_date": "2026-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "2026003856",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "endpointDescription": "BJC",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2122 Troy Rd Ste 130",
            "city": "Edwardsville",
            "state": "IL",
            "country_code": "US",
            "postal_code": "620252540",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "ADEBAYO",
            "last_name": "COKER",
            "middle_name": "OLUSEGUN",
            "prefix": "DR.",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.