SOUTHERN ILLINOIS SPINE & JOINT CENTER OF MARISSA LLC
NPI 1053664557
Chiropractor in Marissa, IL

Q: What is Southern Illinois Spine & Joint Center Of Marissa LLC's specialty?

The primary specialty registered for this NPI is Chiropractor with taxonomy code 111N00000X.

Active since October 22, 2012

112 N MAIN ST, MARISSA, IL 62257(618) 295-2268(618) 295-3521 Get Directions Write a Review

NPPES record last updated: December 12, 2012. Verified against the NPPES registry weekly; last sync: October 25, 2026.

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About Southern Illinois Spine & Joint Center Of Marissa Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SOUTHERN ILLINOIS SPINE & JOINT CENTER OF MARISSA LLC (NPI 1053664557) is a healthcare organization registered as a chiropractor in Marissa, Illinois and active in the NPI registry since October 2012. The organization lists Ryan Reiss, Manager, as its authorized official.

NPPES Registry Identity

NPI1053664557

Entity TypeOrganization

Primary Taxonomy111N00000X

Legal Business NameSOUTHERN ILLINOIS SPINE & JOINT CENTER OF MARISSA LLC

Location Address112 N MAIN STMarissa, IL 62257-1365

Mailing Address112 N Main StMarissa, IL 62257-1365 · (618) 295-2268 · Fax (618) 295-3521

Phone(618) 295-2268

Fax(618) 295-3521

Organization SubpartNo

Authorized OfficialRyan ReissManager · (618) 443-2026

Enumeration DateOctober 22, 2012

Last NPPES UpdateDecember 12, 2012

✔ NPI 1053664557 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyChiropractorChiropractic Providers

Taxonomy Code111N00000X

License✔ Licensed in IL · 038011854

Definition

A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems.

112 N MAIN ST, Marissa, IL 62257

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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Southern Illinois Spine & Joint Center Of Marissa Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Southern Illinois Spine & Joint Center Of Marissa LLC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Dillon Kaesberg, D.C.

Chiropractic

NPI 1821392952

112 N MAIN ST
Marissa, IL 62257

(618) 295-2268

✔ Accepts MedicareSame address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Southern Illinois Spine & Joint Center Of Marissa LLC's NPI number?

The NPI number for Southern Illinois Spine & Joint Center Of Marissa LLC is 1053664557. It was assigned to this organization in the NPPES registry on October 22, 2012.

Where is Southern Illinois Spine & Joint Center Of Marissa LLC located?

Southern Illinois Spine & Joint Center Of Marissa LLC is located at 112 N Main St, Marissa, IL 62257. The listed phone number is (618) 295-2268.

What is Southern Illinois Spine & Joint Center Of Marissa LLC's specialty?

The primary specialty registered for this NPI is Chiropractor with taxonomy code 111N00000X.

Is Southern Illinois Spine & Joint Center Of Marissa LLC enrolled in Medicare?

Yes. Southern Illinois Spine & Joint Center Of Marissa LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Southern Illinois Spine & Joint Center Of Marissa LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Chiropractic) reassigns their Medicare billing to Southern Illinois Spine & Joint Center Of Marissa LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Southern Illinois Spine & Joint Center Of Marissa LLC was last updated on December 12, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.