Organization Active NPI

Midwest Neurosurgeons, LLC

  • Neurological Surgery Physician
  • Saint Louis, MO
National Provider Identifier
1215378955
Registry record updated Oct 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
Legal business name
MIDWEST NEUROSURGEONS, LLC
Practice address
2901 Union Rd Ste 100
Saint Louis, MO 63125-3972
Phone
(314) 408-0129
Fax
(314) 408-0141
NPI assigned
Jul 10, 2013
Last updated
Oct 26, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
MIDWEST NEUROSURGEONS LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 26, 2024

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

Authorized official

Name
Sonjay Joseph Fonn, DONPI 1053533919
Title
Owner
Phone
(314) 408-0129

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Clinic/Center 261QP3300X
Neurological Surgery Physician 207T00000X Primary

Addresses

Primary practice location

2901 Union Rd Ste 100
Saint Louis, MO 63125-3972

Mailing address

PO Box 614
Cape Girardeau, MO 63702-0614
Phone (573) 651-1687

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address ask@drfonn.com
Direct Messaging Address ask@midwestmedicalservices.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090213000061 MO Part B Supplier - Clinic/Group Practice 8628133360 Receives reassigned benefits from 2 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Cape Girardeau, MO; Saint Louis, MO

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
26D2202481Midwest Neurosurgeons, LLC2901 Union Road, Suite 200, Saint Louis, MO 63125Certificate of waiverNov 27, 2026

National Provider Directory

National Provider Directory
Part of
Midwest Neurosurgeons LLC

Locations

65 Doctors Park
Cpe Girardeau, MO 63703
Phone (573) 651-1687

Interoperability endpoints

  • Direct secure messaging: ask@midwestmedicalservices.org

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1373414400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729900800000",
    "number": "1215378955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 614",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "637020614",
            "telephone_number": "573-651-1687",
            "fax_number": "573-651-8734"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2901 UNION RD STE 100",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631253972",
            "telephone_number": "314-408-0129",
            "fax_number": "314-408-0141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDWEST NEUROSURGEONS, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MIDWEST NEUROSURGEONS LLC",
        "enumeration_date": "2013-07-10",
        "last_updated": "2024-10-26",
        "certification_date": "2024-10-26",
        "status": "A",
        "authorized_official_last_name": "FONN",
        "authorized_official_first_name": "SONJAY",
        "authorized_official_middle_name": "JOSEPH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "314-408-0129",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "261QP3300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Pain",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ask@drfonn.com",
            "affiliation": "N",
            "address_1": "65 Doctors Park Ste A",
            "city": "Cape Girardeau",
            "state": "MO",
            "country_code": "US",
            "postal_code": "637034927",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ask@midwestmedicalservices.org",
            "affiliation": "N",
            "address_1": "2901 Union Rd Ste 200",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631253972",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.