Individual provider Active NPI

Emilye Jessica Grant, PHYSICIAN ASSISTANT

  • Physician Assistant
  • Decatur, IL
National Provider Identifier
1396721189
Registry record updated Oct 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
085005568 Issued in IL
Practice address
1750 E Lake Shore Dr
Decatur, IL 62521-3803
Phone
(217) 464-1750
Fax
(217) 464-1469
NPI assigned
Dec 22, 2005
Last updated
Oct 21, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA200169 LA
Physician Assistant 363A00000X 085005568 IL Primary
Medical Physician Assistant 363AM0700X PA30148 DC

Addresses

Primary practice location

1750 E Lake Shore Dr
Decatur, IL 62521-3803

Mailing address

1750 E Lake Shore Dr
Decatur, IL 62521-3803
Phone (217) 464-1750

Other practice location 1

1000 Health Center Dr
Mattoon, IL 61938-4644
Phone (217) 238-4325

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20150831001650 IL Practitioner - Physician Assistant 2062597685 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Nebraska College of Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sarah Bush Lincoln Health CenterGroup PAC ID 5092614867, 411 clinicians
Decatur Memorial HospitalGroup PAC ID 6204731144, 173 clinicians

Practice addresses (Care Compare)

1000 Health Ctr Dr
Mattoon, IL 61938-4644
Phone (217) 258-2525

2300 N Edward St
Decatur, IL 62526-4163
Phone (217) 876-8121

241 W Weaver Rd
Suite 145B
Forsyth, IL 62535-9766
Phone (217) 876-5220

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
73.88 of 100Reported as group
Quality
63.91
Improvement activities
40
Cost
77.03

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
085005568ILMDPhysician Assistant
PA200169LAMDPhysician Assistant
PA30148DCMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
HSHS Prairie, Inc CurrentSince Aug 1, 2015 Accepting new patients
Taylorville Memorial Hospital CurrentSince Dec 28, 2025 Accepting new patients
Decatur Memorial Hospital CurrentSince Oct 17, 2016 Accepting new patients
Decatur Memorial Hospital CurrentSince Oct 17, 2016 Accepting new patients
Taylorville Memorial Hospital CurrentSince Jan 1, 2025 Accepting new patients
Sarah Bush Lincoln Health Center CurrentSince Feb 2, 2026 Accepting new patients
Sarah Bush Lincoln Health Center CurrentSince Feb 2, 2026 Accepting new patients
Gibson Community Hospital Association Past Accepting new patients

Locations

1750 E Lake Shore Dr
Decatur, IL 62521
Phone (217) 425-2732

1900 E Lake Shore Dr
Ste 330
Decatur, IL 62521
Phone (217) 423-2889

2300 N Edward St
Decatur, IL 62526
Phone (217) 876-3000

2300 N Edward St
Ste 3200
Decatur, IL 62526
Phone (217) 876-3660

241 W Weaver Rd
Ste 145B
Forsyth, IL 62535
Phone (217) 876-5220

1000 Health Center Dr
Mattoon, IL 61938
Phone (217) 258-2389

1512 N Green Mount Rd
O Fallon, IL 62269
Phone (618) 624-0100

201 E Pleasant St
Taylorville, IL 62568
Phone (217) 707-5555

Interoperability endpoints

  • FHIR API: https://fhir-usa.unify.chbase.com/org/stvince-659560ec

Organizations & group practices 9

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1135209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761004800000",
    "number": "1396721189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1750 E LAKE SHORE DR",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625213803",
            "telephone_number": "217-464-1750",
            "fax_number": "217-464-1469"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1750 E LAKE SHORE DR",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625213803",
            "telephone_number": "217-464-1750",
            "fax_number": "217-464-1469"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1000 Health Center Dr",
            "address_purpose": "LOCATION",
            "city": "Mattoon",
            "state": "IL",
            "postal_code": "619384644",
            "country_code": "US",
            "telephone_number": "217-238-4325",
            "fax_number": "217-348-4290",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRANT",
        "first_name": "EMILYE",
        "middle_name": "JESSICA",
        "credential": "PHYSICIAN ASSISTANT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-22",
        "last_updated": "2025-10-21",
        "certification_date": "2025-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "LA",
            "license": "PA200169",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085005568",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "DC",
            "license": "PA30148",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Decatur, IL

Sources for this page

Verify at the official NPI Registry.