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).
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 |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 2086S0102X |
Surgery Specialization: Surgical Critical Care |
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 |
---|---|---|---|---|
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 |
Street Address |
205 N EAST AVE |
City | JACKSON |
State | MI |
Zip Code | 49201-1753 |
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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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 |
Find all providers in zip 49201 |
Taxonomy Code | 2086S0102X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Surgery |
Specialization | Surgical Critical Care |
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. |
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 |
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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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.