W.A. FOOTE MEMORIAL HOSPITAL, INC


Address: 205 N East Ave, Jackson, MI 49201-1753
Phone: 5178417843

W.A. FOOTE MEMORIAL HOSPITAL, INC (NPI# 1306386586) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1306386586
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 49201-1753
Mailing Address Po Box 67000
Department 272801
Detroit
MI 48267-0002
Practice Telephone 5178417843
Practice Fax Number 5178417419
Mailing Telephone 5172057843
Mailing Fax Number 5178417419
Enumeration Date 2017-03-07
Last Update Date 2017-03-07
Authorized Official Name KEVIN LEONARD (VP FINANCE)
Authorized Official Telephone 5178417843
Is Organization Subpart Y
Parent Organization Name HENRY FORD ALLEGIANCE HEALTH GROUP

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 2086S0102X Surgery
Specialization: Surgical Critical Care
1060000044 MI Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
MI 1760437826 05

Other Provider/Organization Names

Other Name Type Code
Henry Ford Allegiance Health Doing Business As Name - Organization

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
1255878062 W.a. Foote Memorial Hospital, Inc Otolaryngology 205 N.east Ave, Jackson, MI 49201 2017-01-31
1023512936 W.a. Foote Memorial Hospital, Inc Clinical Medical Laboratory 4304 Page Ave, Michigan Center, MI 49254-1078 2018-03-23
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

Office Location

Street Address 205 N EAST AVE
City JACKSON
State MI
Zip Code 49201-1753

Providers in the same location

NPI Name Taxonomy Address Enumeration
1295736015 Jackson Radiology Consultants, P.C. Radiology 205 N East Ave, Imaging Department, Jackson, MI 49201-1753 2005-08-02
1053910356 Stephanie Galczyk Physician Assistant 205 N East Ave, Jackson, MI 49201-1753 2020-10-19
1467050948 Nicole Elizabeth Knoth Pharmacist 205 N East Ave, Jackson, MI 49201-1753 2020-10-15
1952918849 Jaclyn Nicole Donovan Nurse Practitioner 205 N East Ave, Jackson, MI 49201-1753 2020-09-25
1518573732 Taylor Petersen Physician Assistant 205 N East Ave, Jackson, MI 49201-1753 2020-09-22
1790391092 Ashley Voss Clinical Nurse Specialist 205 N East Ave, Jackson, MI 49201-1753 2020-09-22
1902411788 Owen Jeffrey Wood Physician Assistant 205 N East Ave, Jackson, MI 49201-1753 2020-09-09
1669083721 Holly Jenski Viaches Occupational Therapist 205 N East Ave, Jackson, MI 49201-1753 2020-08-12
1205446739 Sondos Al Khatib Student in an Organized Health Care Education/Training Program 205 N East Ave, Jackson, MI 49201-1753 2020-08-10
1003433459 Kory Ashton Strong Student in an Organized Health Care Education/Training Program 205 N East Ave, Jackson, MI 49201-1753 2020-07-01
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Providers in the same zip code

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
1255878062 W.a. Foote Memorial Hospital, Inc Otolaryngology 205 N.east Ave, Jackson, MI 49201 2017-01-31
1306212881 Aisha Henderson Social Worker 729 West Michigan Avenue, Jackson, MI 49201 2015-08-19
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Taxonomy Information

Taxonomy Code 2086S0102X
Grouping Allopathic & Osteopathic Physicians
Classification Surgery
Specialization Surgical Critical Care

Taxonomy Definition

A surgeon with expertise in the management of the critically ill and postoperative patient, particularly the trauma victim, who specializes in critical care medicine diagnoses, treats and supports patients with multiple organ dysfunction. This specialist may have administrative responsibilities for intensive care units and may also facilitate and coordinate patient care among the primary physician, the critical care staff and other specialists.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source]
- Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification
- Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1053376889 Loren Douglas Nelson Surgery 445 Flat Creek Dr # 3999, Jackson, WY 83001-9173 2006-04-17
1174093637 Adam Welch Surgery 2500 N State St, Jackson, MS 39216-4500 2018-11-27
1033291778 Robert Eugene Schmieg Jr. Surgery 2500 N State St, Jackson, MS 39216-4500 2006-10-20
1487735122 John M Porter Surgery 2500 N State St, Ummc Department of Surgery, Jackson, MS 39216-4500 2006-10-18

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1467748210 John Dillon Galbraith Surgery 100 Michigan St Ne Ste A501, Grand Rapids, MI 49503 2011-06-21
1215127501 Vinod K Puri Surgery 16001 W. Nine Mile Rd, Providence Hospital, Southfield, MI 48075 2007-08-01
1215090840 Michael S. Malian Surgery 18101 Oakwood Boulevard, Beaumont Hospital, Dearborn Trauma Svcs, Dearborn, MI 48123 2006-12-18
1164594420 James E Hoogeboom Surgery 6290 Burton St Se, Grand Rapids, MI 49546-6775 2006-11-14
1699870865 St. Marys of Michigan Specialists Surgery 4690 Mcleod Dr E, Ste B, Saginaw, MI 48604-2836 2006-09-13
1659371326 Marc L. Cullen Surgery Childrens Hospital of Michigan, 3901 Beaubien Blvd, Detroit, MI 48201 2005-07-26
1518522093 Jamal D Farhan, M.d., P.C. Surgery 1020 Charter Dr Ste A, Flint, MI 48532-3584 2019-05-09
1154863033 United Critical Care Plc Surgery 6071 W Outer Dr, Detroit, MI 48235-2624 2016-11-09
1578941969 John R Montgomery Surgery 1500 E Medical Center Dr, 2110 Tc, Spc 5346, Ann Arbor, MI 48109-5000 2015-05-18
1528477387 Kailyn Sum York Lain Kwong Hing Surgery 221 Michigan St Ne Ste 400, Grand Rapids, MI 49503-2538 2014-08-06
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Competitor

Search similar providers

City JACKSON
Zip Code 49201

Improve Information

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Dataset Information

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.

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