Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Jon Michael Russell

Individual provider Critical Care Medicine Registered Nurse · NPI 1942998513

Jon Michael Russell is a Nurse Practitioner in Bradenton, Florida. Qualified in 2023, 3 years ago. Practices with Cooper Family Medical PLLC, a 19-clinician group and accepts Medicare assignment. Licensed in Florida.

Years since qualifying
3
Licensed in
FL
In the registry since
2023
Specialties on file
2

Practice location Address checks out

5123 4th Avenue Cir E
Bradenton, FL 34208-5620
Phone: (941) 744-5510
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X · Licence 11026893 (FL)
Critical Care Medicine Registered Nurse Taxonomy 163WC0200X · Licence 9457376 (FL)

Record details

NPI number1942998513
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedMay 1, 2023
Last updated in NPPESJuly 5, 2023
Certification dateJuly 5, 2023
Mailing address5123 4th Avenue Cir E, Bradenton, FL 34208-5620

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Group practice Cooper Family Medical Pllc — 19 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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