Provider Demographics
NPI:1336305473
Name:HOPPENFELD, JON-DAVID (MD)
Entity type:Individual
Prefix:DR
First Name:JON-DAVID
Middle Name:
Last Name:HOPPENFELD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 117444
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30368-7444
Mailing Address - Country:US
Mailing Address - Phone:043-232-4557
Mailing Address - Fax:704-323-3956
Practice Address - Street 1:2001 RANDOLPH RD
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28207-1215
Practice Address - Country:US
Practice Address - Phone:704-323-2225
Practice Address - Fax:704-323-3985
Is Sole Proprietor?:No
Enumeration Date:2008-07-29
Last Update Date:2025-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2009019332084N0400X
SC333382084N0400X, 208VP0014X
NC33338208VP0014X
NC2009-01933208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
No2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCNC1111Medicaid
NC1336305473Medicaid
NC5913904Medicaid
NC157AWOtherBCBS
NC5913904Medicaid
NCNC1836AMedicare PIN