Individual provider Active NPI

Justin Edward Child

  • Student in an Organized Health Care Education/Training Program
  • Melbourne, FL
National Provider Identifier
1104738301
Registry record updated Sep 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
8043 Spyglass Hill Rd Ste 102
Melbourne, FL 32940-8563
Phone
(321) 757-6899
NPI assigned
Sep 21, 2026
Last updated
Sep 21, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

8043 Spyglass Hill Rd Ste 102
Melbourne, FL 32940-8563

Mailing address

8043 Spyglass Hill Rd Ste 102
Melbourne, FL 32940-8563
Phone (321) 757-6899

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI Registry JSON

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

{
    "created_epoch": "1789948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789948800000",
    "number": "1104738301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8043 SPYGLASS HILL RD STE 102",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329408563",
            "telephone_number": "321-757-6899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8043 SPYGLASS HILL RD STE 102",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329408563",
            "telephone_number": "321-757-6899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHILD",
        "first_name": "JUSTIN",
        "middle_name": "EDWARD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-09-21",
        "last_updated": "2026-09-21",
        "certification_date": "2026-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Melbourne, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.