MR. RUSSELL KEVIN JR. BROXSON (FNP BC) – Family Nurse Practitioner, NPI 1295587293

MR. RUSSELL KEVIN JR. BROXSON (FNP BC) is a healthcare provider. based in Milton, Florida. specializing in NURSE PRACTITIONER. They hold the professional credentials FNP BC. They hold a License No. 11031992 (FL). The NPI Number for MR. RUSSELL KEVIN JR. BROXSON (FNP BC) is 1295587293

Main info

Male
Sole Proprietor
4 Years Of Experience
Accepts Medicare Assignment
Name
MR. RUSSELL KEVIN JR. BROXSON (FNP BC)
NPI
1295587293
Phone
(850) 449-4801
Address
5228 MEDICINE BOW ST
Enumeration Date
3 April 2024
Last Update Date
16 April 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8506758011
Graduation Year
2022 (4 years ago)
PAC ID
5698212199
Group Practice PAC ID
3577466325
Professional Enrollment ID
I20241115002240
Address ID
FL325651219JA14114STXX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience28
Completeness75
Years active:2State licenses:1Digital endpointsOther names

24,232 NURSE PRACTITIONER in FL

Provider Addresses for MR. RUSSELL KEVIN JR. BROXSON (FNP BC)

  • 5228 MEDICINE BOW ST

    MILTON, FL 325708149

    Phone: (850) 449-4801

    Type: Mailing

  • 14114 ALABAMA ST

    JAY, FL 325651219

    Phone: (850) 675-8000

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2024-11-15

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20241115002240INurse PractitionerFLTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 32570)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 3577466325View full group profile
NameSpecialtyState
Nurse PractitionerFL
-FL
Family PracticeFL
Family PracticeFL

Reviews

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Frequently asked questions

Can I verify MR. RUSSELL KEVIN JR. BROXSON (FNP BC) with an NPI only?
You can start verification with NPI 1295587293 for MR. RUSSELL KEVIN JR. BROXSON (FNP BC), then check state licensing separately.
Is MR. RUSSELL KEVIN JR. BROXSON (FNP BC) still practicing?
MR. RUSSELL KEVIN JR. BROXSON (FNP BC) is currently listed as active in the public NPI registry.
What is MR. RUSSELL KEVIN JR. BROXSON (FNP BC)'s specialty?
The listing groups MR. RUSSELL KEVIN JR. BROXSON (FNP BC) with Family Nurse Practitioner. Clinical services aligned with this taxonomy classification.
Where is MR. RUSSELL KEVIN JR. BROXSON (FNP BC) based?
MR. RUSSELL KEVIN JR. BROXSON (FNP BC) is tied to Milton, Florida in the data we show; additional addresses may exist on the full record.
How many locations tie to this NPI?
2 practice locations appear in the available data.

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