Individual provider Active NPI

Jeffery Lloyd Broxson, RPH

  • Pharmacist
  • Titusville, FL
National Provider Identifier
1013114578
Registry record updated Feb 12, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PS0030572 Issued in FL
Practice address
3275 Garden St
Titusville, FL 32796-3004
Phone
(321) 267-1233
NPI assigned
Jun 28, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PS0030572 FL Primary

Addresses

Primary practice location

3275 Garden St
Titusville, FL 32796-3004

Mailing address

3275 Garden St
Titusville, FL 32796-3004
Phone (321) 267-1233

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
PS0030572FLMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Publix Super Markets Inc Past Accepting new patients
Publix Super Markets Inc Past 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": "1182988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1360627200000",
    "number": "1013114578",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3275 GARDEN ST",
            "city": "TITUSVILLE",
            "state": "FL",
            "postal_code": "327963004",
            "telephone_number": "321-267-1233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3275 GARDEN ST",
            "city": "TITUSVILLE",
            "state": "FL",
            "postal_code": "327963004",
            "telephone_number": "321-267-1233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROXSON",
        "first_name": "JEFFERY",
        "middle_name": "LLOYD",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-28",
        "last_updated": "2013-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PS0030572",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Titusville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.