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AXIOM GARDENS OF MOUNT VERNON LLC
NPI 1639906126
Durable Medical Equipment & Medical Supplies in Mount Vernon, IL

Active since September 18, 2024CLIA 14D2321261 · Waiver
5 DOCTORS PARK RD, MOUNT VERNON, IL 62864(618) 242-1064 Get Directions Write a Review

NPPES record last updated: September 18, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Axiom Gardens Of Mount Vernon Llc NPPES

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

AXIOM GARDENS OF MOUNT VERNON LLC (NPI 1639906126), doing business as Axiom Gardens Of Mount Vernon, is a healthcare organization registered as a durable medical equipment & medical supplies in Mount Vernon, Illinois and active in the NPI registry since September 2024. The organization holds a CLIA Waiver certificate valid through March 31, 2027 and lists Jennifer Spector, Vp Of Revenue Cycle Management, as its authorized official.

NPPES Registry Identity

NPI1639906126
Entity TypeOrganization
Primary Taxonomy332B00000X
Legal Business NameAXIOM GARDENS OF MOUNT VERNON LLC
Location Address5 DOCTORS PARK RDMount Vernon, IL 62864-6224
Mailing Address4655 W Chase AveLincolnwood, IL 60712-1605 · (847) 262-3800
Phone(618) 242-1064
Organization SubpartNo
Authorized OfficialJennifer SpectorVp Of Revenue Cycle Management · (847) 262-3800
Enumeration DateSeptember 18, 2024
NPPES CertifiedSeptember 18, 2024
✔ NPI 1639906126 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDurable Medical Equipment & Medical SuppliesSuppliers
Taxonomy Code332B00000X
Definition
A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient's use in the home and that are usable for an extended period of time.
5 DOCTORS PARK RD, Mount Vernon, IL 62864
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Other Names 1

Doing Business AsAxiom Gardens Of Mount Vernon

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 14D2321261

Axiom Gardens Of Mount Vernon · Mount Vernon, IL
Active · expires Mar 31, 2027
CLIA Number14D2321261
Laboratory TypeSkilled Nursing Facility/Nursing Facility
Certificate Effective DateApril 1, 2025
Certificate Expiration DateMarch 31, 2027
Laboratory DirectorKiersten Osborne
Laboratory Phone(618) 242-1064
Laboratory LocationAxiom Gardens Of Mount Vernon5 Doctors Park Rd, Mount Vernon, IL 62864
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 4

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

AMANDA JO PORTER OTR/L
Occupational Therapist
5 DOCTORS PARK RD
MOUNT VERNON, IL 62864
Jefferson County (618) 242-1064
CARAVILLA RESIDENTIAL CENTERS, INC
Nursing Facility/Intermediate Care Facility
5 DOCTORS PARK RD
MOUNT VERNON, IL 62864
Jefferson County (618) 242-1064
AXIOM GARDENS OF MOUNT VERNON LLC
Skilled Nursing Facility
5 DOCTORS PARK RD
MOUNT VERNON, IL 62864
Jefferson County (618) 242-1064
PETERSEN MANAGEMENT COMPANY, LLC
Nursing Facility/Intermediate Care Facility
5 DOCTORS PARK RD
MOUNT VERNON, IL 62864
Jefferson County (618) 242-1064

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 Axiom Gardens Of Mount Vernon LLC's NPI number?

The NPI number for Axiom Gardens Of Mount Vernon LLC is 1639906126. It was assigned to this organization in the NPPES registry on September 18, 2024. The provider is doing business as Axiom Gardens Of Mount Vernon.

Where is Axiom Gardens Of Mount Vernon LLC located?

Axiom Gardens Of Mount Vernon LLC is located at 5 Doctors Park Rd, Mount Vernon, IL 62864. The listed phone number is (618) 242-1064.

What is Axiom Gardens Of Mount Vernon LLC's specialty?

The primary specialty registered for this NPI is Durable Medical Equipment & Medical Supplies with taxonomy code 332B00000X.

Does Axiom Gardens Of Mount Vernon LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 14D2321261) is associated with this NPI, valid through March 31, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Axiom Gardens Of Mount Vernon LLC was last updated on September 18, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 22 months 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.