Individual provider Active NPI

Emma Ann Kemink Herndl, PA-C

  • Physician Assistant
  • Senoia, GA
National Provider Identifier
1043908916
Registry record updated Mar 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
12762 Issued in GA
Practice address
48 Main St Ste 3a
Senoia, GA 30276-1895
Phone
(770) 463-4644
Fax
(770) 599-9779
NPI assigned
Apr 27, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 16, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 12762 GA Primary

Addresses

Primary practice location

48 Main St Ste 3a
Senoia, GA 30276-1895

Mailing address

96 Senoia Rd
Fairburn, GA 30213-1532
Phone (616) 843-6129

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250418001932 GA Practitioner - Physician Assistant 8527596824 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Palmetto Health Council Inc CurrentSince Nov 1, 2024 Accepting new patients
Palmetto Health Council, Inc. Past Accepting new patients

Locations

101 Commerce Pl
Ste 1
Barnesville, GA 30204
Phone (770) 358-4408

202 Croft St
Carrollton, GA 30117
Phone (770) 834-2255

643 Main St
Palmetto, GA 30268
Phone (404) 929-8824

507 Park St
Palmetto, GA 30268
Phone (770) 463-3307

48 Main St
Ste 3A
Senoia, GA 30276
Phone (678) 633-3260

16201 Barnesville St
Zebulon, GA 30295
Phone (770) 567-0334

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/CBJFCA/Endpoint/CBJFCA

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": "1682553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773619200000",
    "number": "1043908916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "96 SENOIA RD",
            "city": "FAIRBURN",
            "state": "GA",
            "postal_code": "302131532",
            "telephone_number": "616-843-6129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "48 MAIN ST STE 3A",
            "city": "SENOIA",
            "state": "GA",
            "postal_code": "302761895",
            "telephone_number": "770-463-4644",
            "fax_number": "770-599-9779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERNDL",
        "first_name": "EMMA",
        "middle_name": "ANN KEMINK",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-04-27",
        "last_updated": "2026-03-16",
        "certification_date": "2026-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "12762",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Senoia, GA

Sources for this page

Verify at the official NPI Registry.