Individual provider Active NPI

Justin Christopher Benton, DPT

  • Physical Therapist
  • Mooresville, NC
National Provider Identifier
1649957408
Registry record updated Apr 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
P23099 Issued in NC
Practice address
539 E Plaza Dr
Mooresville, NC 28115-8011
Phone
(980) 447-9345
NPI assigned
Jul 3, 2023
Last updated
Apr 17, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X P23099 NC Primary

Addresses

Primary practice location

539 E Plaza Dr
Mooresville, NC 28115-8011

Mailing address

PO Box 392573
Pittsburgh, PA 15251-9573
Phone (724) 343-4060

Other practice location 1

805 N Richmond St Ste 103
Fleetwood, PA 19522-1059
Phone (610) 801-1750

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://199.119.81.30:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRResponse_Service Other eSolutions Inc

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240603001631 NC Practitioner - Physical Therapist in Private Practice 7719349885 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Black Mountain Physical Therapy LLCGroup PAC ID 4385896349, 10 clinicians

Practice addresses (Care Compare)

539 E Plaza Dr
Suite R
Mooresville, NC 28115-8012
Phone (980) 447-9345

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Black Mountain Physical Therapy, LLC Physical Therapist CurrentSince May 6, 2024 Accepting new patients

Locations

8215 W 108th Ter
Overland Park, KS 66210

997 Old US Hwy 70 W
Ste D
Black Mtn, NC 28711
Phone (828) 669-6896

10610 Metromont Pkwy
Ste 108
Charlotte, NC 28269
Phone (980) 938-0693

539 E Plaza Dr
Ste R
Mooresville, NC 28115
Phone (980) 447-9345

2000 Westinghouse Dr
Ste 200
Cranberry Twp, PA 16066
Phone (724) 584-5739

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1688342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744848000000",
    "number": "1649957408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 392573",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152519573",
            "telephone_number": "724-343-4060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "539 E PLAZA DR",
            "city": "MOORESVILLE",
            "state": "NC",
            "postal_code": "281158011",
            "telephone_number": "980-447-9345"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "805 N Richmond St Ste 103",
            "address_purpose": "LOCATION",
            "city": "Fleetwood",
            "state": "PA",
            "postal_code": "195221059",
            "country_code": "US",
            "telephone_number": "610-801-1750",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BENTON",
        "first_name": "JUSTIN",
        "middle_name": "CHRISTOPHER",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-07-03",
        "last_updated": "2025-04-17",
        "certification_date": "2025-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "P23099",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://199.119.81.30:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRResponse_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.1066.1",
            "affiliationName": "eSolutions Inc",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CSV",
            "address_1": "8215 W 108th Ter",
            "city": "Overland Park",
            "state": "KS",
            "country_code": "US",
            "postal_code": "662101661",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Mooresville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 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.