Individual provider Active NPI

Emmy Gael Crain

  • Registered Nurse
  • Carbondale, IL
National Provider Identifier
1114517265
Registry record updated Oct 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
041532408 Issued in IL
Practice address
521 N Allyn St
Carbondale, IL 62901-1301
Phone
(618) 203-5882
NPI assigned
Jan 22, 2021
Last updated
Oct 15, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 041532408 IL Primary

Addresses

Primary practice location

521 N Allyn St
Carbondale, IL 62901-1301

Mailing address

521 N Allyn St
Carbondale, IL 62901-1301
Phone (618) 203-5882

Other identifiers 1

IdentifierTypeStateIssuer
043129609OtherILILLINOIS DEPARTMENT OF FEDERAL AND PROFESSIONAL REGULATION

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL Herrin Direct

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

State licenses

LicenseStateTypeSpecialty
043129609ILMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1611273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1792022400000",
    "number": "1114517265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "521 N ALLYN ST",
            "city": "CARBONDALE",
            "state": "IL",
            "postal_code": "629011301",
            "telephone_number": "618-203-5882"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "521 N ALLYN ST",
            "city": "CARBONDALE",
            "state": "IL",
            "postal_code": "629011301",
            "telephone_number": "618-203-5882"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRAIN",
        "first_name": "EMMY",
        "middle_name": "GAEL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-22",
        "last_updated": "2026-10-15",
        "certification_date": "2026-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IL",
            "license": "041532408",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ILLINOIS DEPARTMENT OF FEDERAL AND PROFESSIONAL REGULATION",
            "identifier": "043129609",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Herrin",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "920 N 11th St",
            "city": "Herrin",
            "state": "IL",
            "country_code": "US",
            "postal_code": "629482802",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Carbondale, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2026; 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.