WA FOOTE MEMORIAL HOSPITAL (NPI# 1457563223) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457563223 |
| Entity Type | Organization |
| Organization Name | WA FOOTE MEMORIAL HOSPITAL |
| Other Organization Name | ON HOLD |
| Practice Address |
205 N East Ave Jackson MI 49201-1753 |
| Mailing Address |
Po Box 67000 Department 272801 Detroit MI 48267-2728 |
| Practice Telephone | 5177884800 |
| Mailing Telephone | 5178416913 |
| Mailing Fax Number | 5178416917 |
| Enumeration Date | 2007-05-04 |
| Last Update Date | 2008-05-14 |
| Authorized Official Name | MS. JEANNE' WICKENS (SENIOR VICE PRESIDENT OF FINANCE) |
| Authorized Official Telephone | 5177886979 |
| Authorized Official Credential | CFO |
| Is Organization Subpart | Y |
| Parent Organization Name | WA FOOTE MEMORIAL HOSPITAL |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2300X |
Clinic/Center Specialization: Primary Care |
MI | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| ON HOLD | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700355195 | Wa Foote Memorial Hospital | Family Medicine | 205 N East Ave, Jackson, MI 49201-1753 | 2018-11-15 |
| 1871773481 | Wa Foote Memorial Hospital | Internal Medicine | 205 N East Ave, Jackson, MI 49201-1753 | 2007-11-12 |
| 1851500144 | Wa Foote Memorial Hospital | Surgery | 205 N East Ave, Jackson, MI 49201-1753 | 2007-05-22 |
| 1134335581 | Wa Foote Memorial Hospital | Counselor | 205 N East Ave, Jackson, MI 49201-1753 | 2007-05-15 |
| 1982825139 | Wa Foote Memorial Hospital | Orthopaedic Surgery | 205 N East Ave, Jackson, MI 49201-1753 | 2007-05-02 |
| 1174644058 | Wa Foote Memorial Hospital | Social Worker | 205 N East Ave, Jackson, MI 49201-1753 | 2007-04-02 |
| 1285786434 | Wa Foote Memorial Hospital | General Acute Care Hospital | 205 N East Ave, Jackson, MI 49201-1753 | 2007-01-17 |
| 1962579227 | Wa Foote Memorial Hospital | Urology | 205 N East Ave, Jackson, MI 49201-1753 | 2006-11-29 |
| 1861596124 | Wa Foote Memorial Hospital | Clinic/Center | 205 N East Ave, Jackson, MI 49201-1753 | 2006-09-08 |
| 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 |
| Find all providers in the same location | ||||
| 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 | 261QP2300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Primary Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710545488 | Primary and Behavioral Healthcare Services, Pa | Clinic/Center | 717 E. Fortification St., Jackson, MS 39202-2402 | 2019-05-29 |
| 1366928087 | Primary Care - South Limited | Clinic/Center | 1385 South Highland Ave, Suite B-1, Jackson, TN 38301 | 2018-07-16 |
| 1114427507 | Advance Care, LLC | Clinic/Center | 14 Northtown Dr Ste 105, Jackson, MS 39211-3018 | 2018-02-13 |
| 1467841742 | Dc Medical Services Inc | Clinic/Center | 7 Stonebridge Blvd Ste C, Jackson, TN 38305-2049 | 2015-01-09 |
| 1558779728 | Rural Health Group, Inc. | Clinic/Center | 9742 Nc Highway 305, Jackson, NC 27845-9799 | 2014-07-31 |
| 1043573199 | Fondren Medical Clinic | Clinic/Center | 4436 N State St, Suite A-1, Jackson, MS 39206-5334 | 2012-06-22 |
| 1043503832 | Mid Jackson Family Health Clinic | Clinic/Center | 514c Woodrow Wilson Dr, Jackson, MS 39216 | 2011-05-26 |
| 1053646190 | More Convenient Care Center LLC | Clinic/Center | 4612 Medgar Evers Blvd, Suite 10, Jackson, MS 39213-5205 | 2009-10-07 |
| 1518121326 | University Nursing Associates Pllc | Clinic/Center | 136 W Ash St, Jackson, MS 39202-2217 | 2008-07-11 |
| 1114194347 | Community Action Committee of Pike County | Clinic/Center | 14590 St Rt 93, Family Health Center Jackson, Jackson, OH 45640 | 2008-05-16 |
| 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.