PARKWAY SHOE REPAIR SERVICE
NPI 1194078816
Prosthetic/Orthotic Supplier in Mount Vernon, IL

Q: What is Vivian L Martin's NPI number?

The NPI number for Vivian L Martin is 1194078816. It was assigned to this organization in the NPPES registry on October 18, 2012. The provider is doing business as Parkway Shoe Repair Service.

Q: What is Vivian L Martin's specialty?

The primary specialty registered for this NPI is Prosthetic/Orthotic Supplier with taxonomy code 335E00000X.

Q: When was this NPI record last updated?

The NPPES record for Vivian L Martin was last updated on October 18, 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.

Active since October 18, 2012

1024 JORDAN ST, MOUNT VERNON, IL 62864(618) 242-4442(618) 242-3942 Get Directions Write a Review

NPPES record last updated: October 18, 2012. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Parkway Shoe Repair Service NPPES

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

PARKWAY SHOE REPAIR SERVICE (NPI 1194078816) is a healthcare organization registered as a prosthetic/orthotic supplier in Mount Vernon, Illinois and active in the NPI registry since October 2012. The organization lists Vivian Lea Martin, Owner, as its authorized official.

NPPES Registry Identity

NPI1194078816

Entity TypeOrganization

Primary Taxonomy335E00000X

Legal Business NameVIVIAN L MARTIN

Location Address1024 JORDAN STMount Vernon, IL 62864-4231

Mailing Address1024 Jordan StMount Vernon, IL 62864-4231 · (618) 242-4442 · Fax (618) 242-3942

Phone(618) 242-4442

Fax(618) 242-3942

Organization SubpartNo

Authorized OfficialVivian Lea MartinOwner · (618) 242-4442

Enumeration DateOctober 18, 2012

✔ NPI 1194078816 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyProsthetic/Orthotic SupplierSuppliers

Taxonomy Code335E00000X

Definition

An organization that provides prosthetic and orthotic care which may include, but is not limited to, patient evaluation, prosthesis or orthosis design, fabrication, fitting and modification to treat limb loss for purposes of restoring physiological function and/or cosmesis or to treat a neuromusculoskeletal disorder or acquired condition.

1024 JORDAN ST, Mount Vernon, IL 62864

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Other Names 1

Doing Business AsParkway Shoe Repair Service

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MR. MARIO DONALD HODGE C.PED

Pedorthist

1024 JORDAN ST
MOUNT VERNON, IL 62864

Jefferson County (618) 242-4442

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 Vivian L Martin's NPI number?

The NPI number for Vivian L Martin is 1194078816. It was assigned to this organization in the NPPES registry on October 18, 2012. The provider is doing business as Parkway Shoe Repair Service.

Where is Vivian L Martin located?

Vivian L Martin is located at 1024 Jordan St, Mount Vernon, IL 62864. The listed phone number is (618) 242-4442.

What is Vivian L Martin's specialty?

The primary specialty registered for this NPI is Prosthetic/Orthotic Supplier with taxonomy code 335E00000X.

When was this NPI record last updated?

The NPPES record for Vivian L Martin was last updated on October 18, 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.