NPIMap

Organization Active NPI

Southeast Missouri Anesthesia Services, LLC

  • Anesthesiology Physician
  • Cape Girardeau, MO
National Provider Identifier
1649618547
Registry record updated Nov 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
SOUTHEAST MISSOURI ANESTHESIA SERVICES, LLC
Practice address
65 Doctors Park Ste a
Cape Girardeau, MO 63703-4927
Phone
(573) 651-1687
Fax
(573) 651-8734
NPI assigned
Jun 13, 2013
Last updated
Nov 18, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2020

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

Authorized official

Name
Dr. Sonjay Joseph Fonn, DONPI 1053533919
Title
Owner/Ceo
Phone
(573) 651-1687

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X MO Primary

Addresses

Primary practice location

65 Doctors Park Ste a
Cape Girardeau, MO 63703-4927

Mailing address

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

Other practice location 1

2901 Union Rd Ste 200
Saint Louis, MO 63125-3972
Phone (314) 626-3602

Other identifiers 1

IdentifierTypeStateIssuer
2008003433OtherMOSTATE BOARD

Electronic endpoints 3

TypeEndpointUseAffiliation
Direct Messaging Address ask@drfonn.com Midwest Neurosurgeons LLC
Other URL ask@drfonn.com Health Information Exchange (HIE)
Direct Messaging Address ask@midwestfamilyclinic.com

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140108001115 MO Part B Supplier - Clinic/Group Practice 6204064736 Receives reassigned benefits from 1 practitioner
Practice locations: Cape Girardeau, MO

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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": "1371081600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1605657600000",
    "number": "1649618547",
    "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": "65 DOCTORS PARK STE A",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "637034927",
            "telephone_number": "573-651-1687",
            "fax_number": "573-651-8734"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2901 Union Rd Ste 200",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631253972",
            "country_code": "US",
            "telephone_number": "314-626-3602",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SOUTHEAST MISSOURI ANESTHESIA SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-06-13",
        "last_updated": "2020-11-18",
        "certification_date": "2020-11-18",
        "status": "A",
        "authorized_official_last_name": "FONN",
        "authorized_official_first_name": "SONJAY",
        "authorized_official_middle_name": "JOSEPH",
        "authorized_official_title_or_position": "OWNER/CEO",
        "authorized_official_telephone_number": "573-651-1687",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MO",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE BOARD",
            "identifier": "2008003433",
            "state": "MO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ask@drfonn.com",
            "affiliation": "Y",
            "affiliationName": "Midwest Neurosurgeons LLC",
            "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": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "ask@drfonn.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "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@midwestfamilyclinic.com",
            "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 Cape Girardeau, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.