Carson Blaine Fonner, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

2025017923 Issued in MO

Practice address

4240 Duncan Ave
Dept Physical Therapy, Ste 120
Saint Louis, MO 63110-1101

Phone

(314) 286-1940

Fax

(314) 286-1473

NPI assigned

Feb 22, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CO, MO2 enrollments

Enrollment records 2

Specialty

Physical Therapist in Private Practice

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Washington UniversityGroup PAC ID 9830008770, 2,968 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

96.68 of 100Reported as group

Quality

96.09

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Washington University

  • Physical Therapy Clinic/Center
  • Saint Louis, MO
  • NPI 1922048420

  Physical Therapist

  Medicare reassignment Care Compare group NPD
• Panorama Orthopedics and Spine Center PC

  • Orthopaedic Surgery Physician
  • Golden, CO
  • NPI 1295787950
  Medicare reassignment NPD
• Washington University

  • Multi-Specialty Clinic/Center
  • Saint Louis, MO
  • NPI 1962442475
  NPD
• Panorama Orthopedics & Spine Center, PC

  • Physical Therapy Clinic/Center
  • Colorado Springs, CO
  • NPI 1124730742
  NPD
• Panorama Orthopedics & Spine Center, PC

  • Physical Therapy Clinic/Center
  • Colorado Springs, CO
  • NPI 1194390518
  NPD

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

{
    "created_epoch": "1677024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750377600000",
    "number": "1649978263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7412011",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606742011",
            "telephone_number": "314-286-1940",
            "fax_number": "314-286-1473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4240 DUNCAN AVE",
            "address_2": "DEPT PHYSICAL THERAPY, STE 120",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631101101",
            "telephone_number": "314-286-1940",
            "fax_number": "314-286-1473"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FONNER",
        "first_name": "CARSON",
        "middle_name": "BLAINE",
        "name_prefix": "Ms.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-02-22",
        "last_updated": "2025-06-20",
        "certification_date": "2023-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MO",
            "license": "2025017923",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "Y",
            "affiliationName": "Washington University",
            "address_1": "4240 Duncan Ave",
            "address_2": "Dept Physical Therapy, Ste 120",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631101101",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Wyatt Andrew Fones
• Brendan Manuel Fong, M.D.
• Jerry Fong, MD
• Thomas H. Fong, M.D.
• Wing Man Fong, PHD
• Ricardo Alejandro Fonseca Ruiz, MD
• Fontana Eyecare Associates, LLC.
• Carolina Fonte Suau, C-AA
• Debra Lynn Fontenot, M.S.W. L.C.S.W.
• Foot & Ankle Center, LLC

• Physical Therapist in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Physical Therapist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2025; 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.