Active NPI
Jay Reiss, OTD
- Occupational Therapist
- Mount Vernon, IL
National Provider Identifier
1558275511
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 056027321
- Practice address
- 4121 Veterans Memorial Dr
Mount Vernon, IL 62864-6262 - Phone
- (618) 214-4685
- NPI assigned
- Sep 29, 2026
- Last updated
- Sep 29, 2026
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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.