Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Emily Ann Berry, PA-C

Individual provider Physician Assistant · NPI 1053290114

Emily Ann Berry, PA-C is a Physician Assistant in Carbondale, Illinois. Graduated from Southern Illinois University School of Medicine in 2025, 1 year ago. Practices with Legacy Dermatology PLLC, a 2-clinician group and accepts Medicare assignment. Licensed in Illinois.

Years since qualifying
1
Trained at
Southern Illinois University School of Medicine
Licensed in
IL
In the registry since
2025
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

300 W Oak St
Carbondale, IL 62901-1400
Phone: (618) 536-6621
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X (IL)

Record details

NPI number1053290114
Entity typeIndividual (Type 1)
GenderNot disclosed
Credentials PA-C
Sole proprietorNo
NPI enumeratedSeptember 1, 2025
Last updated in NPPESNovember 19, 2025
Certification dateNovember 19, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolSOUTHERN ILLINOIS UNIVERSITY SCHOOL OF MEDICINE
Graduated 2025 (1 years in practice)
Group practice Legacy Dermatology Pllc — 2 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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