OrganizationActive
Vivian L Martin
NPI 1194078816 · Prosthetic/Orthotic Supplier · Mount Vernon, IL
Vivian L Martin is a Prosthetic/Orthotic Supplier organization in Mount Vernon, IL (NPI 1194078816).
Provider details
- NPI number
- 1194078816
- Entity type
- Organization
- Primary specialty
- Prosthetic/Orthotic SupplierSuppliers
- Organization subpart
- No
- Authorized official
- Vivian Martin, Owner(618) 242-4442
Specialties & taxonomies
Suppliers
Profile Score
Detailed profile(79/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
13 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
1024 Jordan St
Mount Vernon, IL 62864-4231
Phone: (618) 242-4442
Fax: (618) 242-3942
Street-level locationGet directions
Mailing address
1024 Jordan St
Mount Vernon, IL 62864-4231
Other names (DBA / former)
- Doing business as
- Parkway Shoe Repair Service
Registry dates
- Enumerated
- 2012-10-18
- Last updated
- 2012-10-18
Frequently asked questions
- What is Vivian L Martin's NPI number?
- Vivian L Martin's National Provider Identifier (NPI) is 1194078816, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Vivian L Martin?
- Vivian L Martin is classified in the NPPES registry as Prosthetic/Orthotic Supplier (Suppliers).
- Where is Vivian L Martin located?
- Vivian L Martin's practice location on file with NPPES is 1024 Jordan St, Mount Vernon, IL 62864-4231.
- What is Vivian L Martin's phone number?
- The practice phone number listed in the NPPES registry for Vivian L Martin is (618) 242-4442.
- Who is the authorized official for Vivian L Martin?
- The authorized official listed on Vivian L Martin's NPPES record is Vivian Martin, Owner. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Vivian L Martin's NPI active?
- Yes — Vivian L Martin's NPI (1194078816) is active in the NPPES registry as of the last update on 2012-10-18.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.