Mark Jonathan Badenhop, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

P15385 Issued in NC

Practice address

445 S Kings Dr Ste 100
Charlotte, NC 28204

Phone

(704) 384-1737

NPI assigned

Aug 9, 2010

Last updated

Aug 22, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mbadenhop667162@direct.novanthealth.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• JP2 Physical Therapy LLC

  • Physical Therapy Clinic/Center
  • Charlotte, NC
  • NPI 1689456774

  Physical Therapist

  NPD
• Foundation Health Systems LLC

  dba Novant Health Rehabilitation Center

  • Physical Therapy Clinic/Center
  • Winston Salem, NC
  • NPI 1205894029

  Physical Therapist

  NPD (past)

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

{
    "created_epoch": "1281312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724284800000",
    "number": "1447565981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60447",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282600447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "445 S KINGS DR STE 100",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "28204",
            "telephone_number": "704-384-1737"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2106 Executive Dr",
            "address_purpose": "LOCATION",
            "city": "Hampton",
            "state": "VA",
            "postal_code": "236662402",
            "country_code": "US",
            "telephone_number": "757-838-6678",
            "fax_number": "757-838-8116",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BADENHOP",
        "first_name": "MARK",
        "middle_name": "JONATHAN",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-08-09",
        "last_updated": "2024-08-22",
        "certification_date": "2024-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "13050",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "P15385",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "9082561",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1447565981",
            "state": "VA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mbadenhop667162@direct.novanthealth.org",
            "affiliation": "N",
            "address_1": "2106 Executive Dr",
            "city": "Hampton",
            "state": "VA",
            "country_code": "US",
            "postal_code": "236662402",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Rupal Naresh Badalyan, MD
• Sara Nelly Badano, MD
• Poornima Baddi, MD
• Krishnamohan R Baddigam, MD
• Isabel Badeau
• Jillian Nicole Badger-Reyes, PA
• Hanna Moore Badger, PT
• Lori M. Badgley, MA, CCC-SLP
• Chirsteen Badie, LGSWA
• Haddyjatou Badjan

• Physical Therapist in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Physical Therapist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.