Individual provider Active NPI

Julie C. Child, FNP-BC

  • Family Nurse Practitioner
  • Brigham City, UT
National Provider Identifier
1437147576
Registry record updated Sep 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2167524405 Issued in UT
Practice address
1050 South Medical Drive
Ste 101
Brigham City, UT 84302
Phone
(435) 538-1733
Fax
(435) 538-1752
NPI assigned
Oct 12, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 2167524405 UT Primary

Addresses

Primary practice location

1050 South Medical Drive
Ste 101
Brigham City, UT 84302

Mailing address

1050 South Medical Drive
Ste 101
Brigham City, UT 84302
Phone (435) 538-1733

Other identifiers 1

IdentifierTypeStateIssuer
09709MedicaidUT

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address julie.child@direct.imail.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080725000105 UT Practitioner - Nurse Practitioner 6800969767 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
2167524405UTMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Wound Care of Utah PLLC CurrentSince Aug 15, 2024 Accepting new patients

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1129075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632960000000",
    "number": "1437147576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1050 SOUTH MEDICAL DRIVE",
            "address_2": "STE 101",
            "city": "BRIGHAM CITY",
            "state": "UT",
            "postal_code": "84302",
            "telephone_number": "435-538-1733",
            "fax_number": "435-538-1752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1050 SOUTH MEDICAL DRIVE",
            "address_2": "STE 101",
            "city": "BRIGHAM CITY",
            "state": "UT",
            "postal_code": "84302",
            "telephone_number": "435-538-1733",
            "fax_number": "435-538-1752"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHILD",
        "first_name": "JULIE",
        "middle_name": "C.",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-12",
        "last_updated": "2021-09-30",
        "certification_date": "2021-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "UT",
            "license": "2167524405",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09709",
            "state": "UT"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "julie.child@direct.imail.org",
            "affiliation": "N",
            "address_1": "1050 South Medical Drive",
            "address_2": "Ste 101",
            "city": "Brigham City",
            "state": "UT",
            "country_code": "US",
            "postal_code": "84302",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Brigham City, UT

Sources for this page

Verify at the official NPI Registry.