Conner Jackson Russell

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

1400 Executive Pkwy Ste 250
Eugene, OR 97401-7104

Phone

(971) 300-0654

NPI assigned

Mar 4, 2026

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Specialty

Physician Assistant

Education

Creighton University School of Medicine, 2025

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Robert Olsen MD LLC

  • Psychiatry Physician
  • Portland, OR
  • NPI 1902565930
  NPD

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

{
    "created_epoch": "1772582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772582400000",
    "number": "1861348724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4427 N JOEY CT",
            "city": "LITCHFIELD PARK",
            "state": "AZ",
            "postal_code": "853405123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 EXECUTIVE PKWY STE 250",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974017104",
            "telephone_number": "971-300-0654"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "CONNER",
        "middle_name": "JACKSON",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-03-04",
        "last_updated": "2026-03-04",
        "certification_date": "2026-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexandra L Russell, MSW, LCSW
• Amanda Roseanne Russell, M.A.
• Amy Christine Russell, LPC
• Autumn Starr Russell, CADC II, QMHA I
• Christi M Russell, SMC FCDBC
• Erin Amelia Russell, M.ED.
• Jennifer Marie Russell
• Joseph Michael John Russell, PA
• Kelly Hanh Russell, PA-C
• Marie Christine Russell

• Physician Assistant in Eugene, OR
• Providers in Eugene, OR by specialty
• Physician Assistant in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.