{"npi":"1053664557","type":"NPI-2","status":"active","name":{"display":"Southern Illinois Spine & Joint Center Of Marissa LLC","other":[],"organization_name":"SOUTHERN ILLINOIS SPINE & JOINT CENTER OF MARISSA LLC","authorised_official":"Ryan Reiss"},"specialty":{"primary_taxonomy":"111N00000X","primary_taxonomy_description":"Chiropractor","slug":"chiropractor","schema_org_specialty":null,"all":[{"code":"111N00000X","description":"Chiropractor","primary":true,"state":"IL","license":"038011854"}]},"addresses":[{"purpose":"LOCATION","street_1":"112 N MAIN ST","city":"MARISSA","state":"IL","postal_code":"622571365","country_code":"US","phone":"6182952268","fax":"6182953521"},{"purpose":"MAILING","street_1":"112 N MAIN ST","city":"MARISSA","state":"IL","postal_code":"622571365","country_code":"US","phone":"6182952268","fax":"6182953521"}],"license":{"state":"IL","number":"038011854"},"identifiers":[],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"O20130118000433","type_code":"12-70","type_desc":"PART B SUPPLIER - CLINIC/GROUP PRACTICE","state":"IL","pac_id":"2466605696"}]},"enumeration_date":"2012-10-22","last_updated":"2012-12-12","_meta":{"source":"NPPES","snapshot_date":"2012-12-12","doc_url":"https://findmynpi.com/api"}}