Individual provider Active NPI

Jay Reiss, OTD

  • Occupational Therapist
  • Mount Vernon, IL
National Provider Identifier
1558275511
Registry record updated Sep 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
056027321 Issued in IL
Practice address
4121 Veterans Memorial Dr
Mount Vernon, IL 62864-6262
Phone
(618) 214-4685
NPI assigned
Sep 29, 2026
Last updated
Sep 29, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 056027321 IL Primary

Addresses

Primary practice location

4121 Veterans Memorial Dr
Mount Vernon, IL 62864-6262

Mailing address

4121 Veterans Memorial Dr
Mount Vernon, IL 62864-6262
Phone (618) 214-4685

Other practice location 1

839 Martin Luther King Drive
Centralia, IL 62801
Phone (618) 242-3778

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI Registry JSON

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

{
    "created_epoch": "1790640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790640000000",
    "number": "1558275511",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4121 VETERANS MEMORIAL DR",
            "city": "MOUNT VERNON",
            "state": "IL",
            "postal_code": "628646262",
            "telephone_number": "618-214-4685"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4121 VETERANS MEMORIAL DR",
            "city": "MOUNT VERNON",
            "state": "IL",
            "postal_code": "628646262",
            "telephone_number": "618-214-4685"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "839 Martin Luther King Drive",
            "address_purpose": "LOCATION",
            "city": "Centralia",
            "state": "IL",
            "postal_code": "62801",
            "country_code": "US",
            "telephone_number": "618-242-3778",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REISS",
        "first_name": "JAY",
        "credential": "OTD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-09-29",
        "last_updated": "2026-09-29",
        "certification_date": "2026-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IL",
            "license": "056027321",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Vernon, IL

Sources for this page

  • 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.

Verify at the official NPI Registry.