Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

MS. Carson Blaine Fonner, DPT

Individual provider Physical Therapist · NPI 1649978263

MS. Carson Blaine Fonner, DPT is a Physical Therapist in Private Practice in Saint Louis, Missouri. Qualified in 2022, 4 years ago. Practices with Washington University, a 2,986-clinician group and accepts Medicare assignment. Licensed in Missouri.

Years since qualifying
4
Licensed in
MO
In the registry since
2023
What do these letters mean?
DPT — Doctor of Physical Therapy
The doctoral degree now required to enter physical therapy practice.

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Practice location Address checks out

4240 Duncan Ave Dept Physical Therapy Ste 120
Saint Louis, MO 63110-1101
Phone: (314) 286-1940
Fax: (314) 286-1473
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence 2025017923 (MO)

Record details

NPI number1649978263
Entity typeIndividual (Type 1)
GenderFemale
Credentials DPT
Sole proprietorNo
NPI enumeratedFebruary 22, 2023
Last updated in NPPESJune 20, 2025
Certification dateFebruary 22, 2023

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice Washington University — 2986 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

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