JACQUELINE MARIE RUSSELL PMHNP-BC
NPI 1720673577
Nurse Practitioner - Psychiatric/Mental Health in Enterprise, OR

Q: What is Jacqueline Russell's NPI number?

The NPI number for Jacqueline Russell is 1720673577. It was assigned to this individual provider in the NPPES registry on March 3, 2021.

Q: What is Jacqueline Russell's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Active since March 03, 2021PECOS Enrolled

606 MEDICAL PKWY, ENTERPRISE, OR 97828(541) 426-4524(541) 426-3035 Get Directions Write a Review

NPPES record last updated: March 1, 2024. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Jul 20, 2023, Mar 3, 2021 (2 updates tracked since 2021).

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About Jacqueline Marie Russell Pmhnp-bc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JACQUELINE MARIE RUSSELL PMHNP-BC (NPI 1720673577) is an individual psychiatric/mental health provider in Enterprise, Oregon, licensed in Oregon (10013334) and active in the NPI registry since March 2021. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1720673577

Entity TypeIndividualFemale

Primary Taxonomy363LP0808X

Provider Legal NameJACQUELINE MARIE RUSSELLCredential: PMHNP-BC

Location Address606 MEDICAL PKWYEnterprise, OR 97828-5140

Mailing Address79571 Leap LnWallowa, OR 97885-7107 · (503) 899-3219 · Fax (541) 426-3035

Phone(541) 426-4524

Fax(541) 426-3035

Sole ProprietorNo

Enumeration DateMarch 3, 2021

Last NPPES UpdateMarch 1, 20242 updates tracked since enumeration

NPPES CertifiedMarch 1, 2024

✔ NPI 1720673577 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LP0808X

License✔ Licensed in OR · 10013334

606 MEDICAL PKWY, Enterprise, OR 97828

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BridgeSpan Health Company, Moda Health Plan, Inc., PacificSource Health Plans and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jacqueline Marie Russell Pmhnp-bc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Jacqueline Russell reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Wallowa Valley Center For Wellness

Same address

Community/Behavioral Health

606 MEDICAL PKWY
Enterprise, OR 97828

Reassigned Medicare billing, Oregon enrollment
10 clinicians in this Medicare group

NPI 1043249907 (541) 426-4524

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 97828 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$84.82 typical visit price

range $54.96 – $166.64

Typical copayment $21.20 (range $13.74 – $41.66)

Most-billed visit code 99203

Established Patient

$97.16 typical visit price

range $17.68 – $136.19

Typical copayment $24.29 (range $4.42 – $34.04)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

WALLOWA VALLEY CENTER FOR WELLNESS

Community/Behavioral Health