Emily Elise Kermicle, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

085004680 Issued in IL

Practice address

305 W Jackson St
Suite 200
Carbondale, IL 62901-1474

Phone

(618) 536-6621

Fax

(618) 453-1102

NPI assigned

Mar 11, 2013

Last updated

Sep 29, 2026By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

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

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Physician Assistant

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Siu Physicians & Surgeons, Inc

  dba SIU HealthCare

  • Endocrinology, Diabetes & Metabolism Physician
  • Springfield, IL
  • NPI 1558385989
  Medicare reassignment NPD
• Southern Illinois Hospital Services

  dba Herrin Hospital

  • General Acute Care Hospital
  • Herrin, IL
  • NPI 1528158573
  Medicare reassignment
• Siu Physicians & Surgeons, Inc

  • Durable Medical Equipment & Medical Supplies
  • Springfield, IL
  • NPI 1164055976
  NPD
• Southern Illinois Hospital Services

  dba West Frankfort Family Medicine

  • Family Medicine Physician
  • West Frankfort, IL
  • NPI 1154408581
  NPD
• Southern Illinois Hospital Services

  dba St. Joseph Memorial Hospital

  • Medicare Defined Swing Bed Hospital Unit
  • Murphysboro, IL
  • NPI 1639595036
  NPD
• Southern Illinois University

  dba Community Nursing Services

  • Clinic/Center
  • E Saint Louis, IL
  • NPI 1306273776
  NPD (past)
• Stratum Health Collective PLLC

  • Integrative Medicine Physician
  • Brentwood, TN
  • NPI 1740121516
  NPD (past)

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

{
    "created_epoch": "1362960000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790640000000",
    "number": "1881935245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "305 W JACKSON ST",
            "address_2": "SUITE 200",
            "city": "CARBONDALE",
            "state": "IL",
            "postal_code": "629011474",
            "telephone_number": "618-536-6621",
            "fax_number": "618-453-1102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 W JACKSON ST",
            "address_2": "SUITE 200",
            "city": "CARBONDALE",
            "state": "IL",
            "postal_code": "629011474",
            "telephone_number": "618-536-6621",
            "fax_number": "618-453-1102"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2553 Ken Gray Blvd",
            "address_purpose": "LOCATION",
            "city": "West Frankfort",
            "state": "IL",
            "postal_code": "628964174",
            "country_code": "US",
            "telephone_number": "618-932-3937",
            "fax_number": "618-932-2734",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KERMICLE",
        "first_name": "EMILY",
        "middle_name": "ELISE",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-03-11",
        "last_updated": "2026-09-29",
        "certification_date": "2020-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085004680",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ekermicle13731@sih.direct-ci.com",
            "affiliation": "N",
            "address_1": "2553 Ken Gray Blvd",
            "city": "West Frankfort",
            "state": "IL",
            "country_code": "US",
            "postal_code": "628964174",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Constance Susan Kemp, M.D.
• Jodie Kennedy, L.C.S.W.
• Gardner Thomas Kenny, M.D.
• Christopher Ryan Kent
• Teresa Ann Kent, LCSW, ACSW
• Sarah Kertz, PH.D.
• Marta Elisa Ketter, SLP M.S.
• Refat Daherdiab Khader, M.D.
• Muhammad A Khan, MD
• Rizwan Ahmad Khan, M.D.

• Physician Assistant in Carbondale, IL
• Providers in Carbondale, IL by specialty
• Physician Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.