W.A. FOOTE MEMORIAL HOSPITAL, INC (NPI# 1255878062) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255878062 |
| Entity Type | Organization |
| Organization Name | W.A. FOOTE MEMORIAL HOSPITAL, INC |
| Other Organization Name | HENRY FORD ALLEGIANCE HEALTH |
| Practice Address |
205 N.east Ave Jackson MI 49201 |
| Mailing Address |
Po Box 67000 Department 272801 Detroit MI 48267 |
| Practice Telephone | 5178417843 |
| Practice Fax Number | 5178417843 |
| Mailing Telephone | 5178417843 |
| Mailing Fax Number | 5178417419 |
| Enumeration Date | 2017-01-31 |
| Last Update Date | 2017-03-01 |
| Authorized Official Name | KEVIN LEONARD (VP FINANCE) |
| Authorized Official Telephone | 5178417843 |
| Is Organization Subpart | Y |
| Parent Organization Name | HENRY FORD ALLEGIANCE HEALTH GROUP |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Y00000X | Otolaryngology | 1060000044 | MI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | 1760437826 | 05 |
| Other Name | Type Code |
|---|---|
| Henry Ford Allegiance Health | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023512936 | W.a. Foote Memorial Hospital, Inc | Clinical Medical Laboratory | 4304 Page Ave, Michigan Center, MI 49254-1078 | 2018-03-23 |
| 1306386586 | W.a. Foote Memorial Hospital, Inc | Surgery | 205 N East Ave, Jackson, MI 49201-1753 | 2017-03-07 |
| 1073051199 | W.a. Foote Memorial Hospital, Inc | Hospitalist | 205 N. East Ave, Attn: Provider Enrollment, Jackson, MI 49201 | 2017-02-09 |
| 1912445677 | W.a. Foote Memorial Hospital, Inc | Psychiatry & Neurology | 205 N. East Ave, Jackson, MI 49201 | 2017-02-02 |
| 1134666936 | W.a. Foote Memorial Hospital, Inc | Dermatology | 205 N. East Ave, Jackson, MI 49201 | 2017-01-31 |
| 1649717448 | W.a. Foote Memorial Hospital, Inc | Surgery | 205 N. East Ave., Jackson, MI 49201 | 2017-01-31 |
| 1538606348 | W.a. Foote Memorial Hospital, Inc | Internal Medicine | 205 N. East Ave, Jackson, MI 49201 | 2017-01-31 |
| 1891232740 | W.a. Foote Memorial Hospital, Inc | Pediatrics | 205 N. East Ave, Jackson, MI 49201 | 2017-01-30 |
| 1356888218 | W.a. Foote Memorial Hospital, Inc | Internal Medicine | 205 N. East Ave, Jackson, MI 49201 | 2017-01-30 |
| 1235676180 | W.a. Foote Memorial Hospital, Inc | Physician Assistant | 205 N. East Ave, Jackson, MI 49201 | 2017-01-30 |
| Street Address |
205 N.EAST AVE |
| City | JACKSON |
| State | MI |
| Zip Code | 49201 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174137863 | Sally Ann Shaw | Behavior Technician | 3699 Miles Rd., Jackson, MI 49201 | 2020-09-01 |
| 1780293043 | Alyn Kristin Kay | Technician | Hope Network-hope's Door Cru, 3699 Miles Rd., Jackson, MI 49201 | 2020-07-23 |
| 1841827946 | Maverick Jubane | Student in an Organized Health Care Education/Training Program | Henry Ford Allegiance Health, 205 N East Avenue, Jackson, MI 49201 | 2020-03-26 |
| 1306486584 | Cody Williams | Technician, Other | 1001 Laurence Avenue St E, Jackson, MI 49201 | 2020-01-15 |
| 1720632292 | Krystie Lynn Adorjan | Speech-Language Pathologist | 1175 W Parnall Rd, Jackson, MI 49201 | 2019-08-01 |
| 1407412653 | Howard Franklin Tanner II | Speech-Language Pathologist | 102 East Michigan Avenue, Jackson, MI 49201 | 2019-05-14 |
| 1356863740 | Rima Zarar Qayyum | Speech-Language Pathologist | 4800 Firethorn Dr., Jackson, MI 49201 | 2017-07-07 |
| 1306384383 | Briana Nesmith | Speech-Language Pathologist | 2025 Ann Arbor Road, Jackson, MI 49201 | 2017-02-09 |
| 1306212881 | Aisha Henderson | Social Worker | 729 West Michigan Avenue, Jackson, MI 49201 | 2015-08-19 |
| 1255715702 | Athletico Ltd | Physical Therapist | 2973 Springport Road, Jackson, MI 49201 | 2015-07-15 |
| Find all providers in zip 49201 | ||||
| Taxonomy Code | 207Y00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Otolaryngology |
| An otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Otolaryngology, 2007. http://www.aboto.org/. American Osteopathic Board of Ophthalmology and Otolaryngology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Otolaryngology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194973941 | Howard B Cheek | Otolaryngology | 4080 Boxwood Circle, Jackson, MS 39211-6609 | 2008-09-05 |
| 1881712057 | Ear Nose & Throat Surgical Group | Otolaryngology | 764 Lakeland Drive, Suite 200, Jackson, MS 39216-4617 | 2007-03-27 |
| 1811076938 | Kyle Ford Gordon | Otolaryngology | 970 Lakeland Dr Ste 40, Jackson, MS 39216-4640 | 2006-11-02 |
| 1285713305 | Andrew Byron Brown IIi | Otolaryngology | 764 Lakeland Dr Ste 200, Jackson, MS 39216-4617 | 2006-11-02 |
| 1780771956 | Tammy Sanders | Otolaryngology | 1500 E. Woodrow Wilson Ave., Jackson, MS 39216-5199 | 2006-10-06 |
| 1922097492 | Stephen L Kirkner | Otolaryngology | 1111 Teneyck St, Suite 100, Jackson, MI 49201-2461 | 2005-10-18 |
| 1720070535 | West Tennessee Ent Clinic, P.a. | Otolaryngology | 619 Skyline Dr, Jackson, TN 38301-3903 | 2005-08-17 |
| 1245795400 | Dr. Patricia A Murphy Pllc | Otolaryngology | 221 Highway 15 S, Jackson, KY 41339-9600 | 2019-02-01 |
| 1336677624 | Wendy Nicole Marino | Otolaryngology | 764 Lakeland Dr, Jackson, MS 39216-4651 | 2017-05-31 |
| 1376997957 | Jaxon William Jordan | Otolaryngology | 2500 N State St, Department of Otolaryngology, Jackson, MS 39216-4500 | 2016-04-20 |
| Find all providers in JACKSON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.