Individual provider Active NPI

Rebecca Killian Edmondson

  • Physician Assistant
  • Marion, IL
National Provider Identifier
1891136313
Registry record updated May 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
085004711 Issued in IL
Practice address
1306 N Atchison Ave Ste B
Marion, IL 62959-5426
Phone
(618) 988-6000
Fax
(618) 942-7111
NPI assigned
Jul 12, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 11, 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 085004711 IL Primary

Addresses

Primary practice location

1306 N Atchison Ave Ste B
Marion, IL 62959-5426

Mailing address

1306 N Atchison Ave Ste B
Marion, IL 62959-5426
Phone (618) 988-6000

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
I20130812000092 IL Practitioner - Physician Assistant 7416199005 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Priority Integrated Healthcare PCGroup PAC ID 3779948245, 4 clinicians

Practice addresses (Care Compare)

1306 N Atchison Ave
Marion, IL 62959-5426
Phone (618) 988-6000

905 S Park Ave
Herrin, IL 62948-4112

Hospital & facility affiliations

  • Northwestern Medicine Central Dupage Hospital Hospital, Winfield, IL, CCN 140242
  • Herrin Hospital Hospital, Herrin, IL, CCN 140011
  • Memorial Hospital of Carbondale Hospital, Carbondale, IL, CCN 140164
  • Heartland Regional Medical Center Hospital, Marion, IL, CCN 140184

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
085004711ILMDPhysician Assistant

Organizations & group practices 1

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.

Hospital & facility affiliations 5

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": "1373587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778457600000",
    "number": "1891136313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1306 N ATCHISON AVE STE B",
            "city": "MARION",
            "state": "IL",
            "postal_code": "629595426",
            "telephone_number": "618-988-6000",
            "fax_number": "618-942-7111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1306 N ATCHISON AVE STE B",
            "city": "MARION",
            "state": "IL",
            "postal_code": "629595426",
            "telephone_number": "618-988-6000",
            "fax_number": "618-942-7111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDMONDSON",
        "first_name": "REBECCA",
        "middle_name": "KILLIAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-12",
        "last_updated": "2026-05-11",
        "certification_date": "2026-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085004711",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marion, IL

Sources for this page

Verify at the official NPI Registry.