W.A. FOOTE MEMORIAL HOSPITAL, INC (NPI# 1912445677) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912445677 |
| 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 | 5178417419 |
| Mailing Telephone | 5178417843 |
| Mailing Fax Number | 5178417419 |
| Enumeration Date | 2017-02-02 |
| Last Update Date | 2019-08-06 |
| Authorized Official Name | MARK SMITH (SVP - CMO, CEO - HFAMG) |
| Authorized Official Telephone | 5172056407 |
| Authorized Official Credential | MD |
| Is Organization Subpart | Y |
| Parent Organization Name | HENRY FORD ALLEGIANCE HEALTH GROUP |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
1060000044 | MI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | 1326078866 | 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 |
| 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 |
| 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 |
|---|---|---|---|---|
| 1780776138 | W.a. Foote Memorial Hospital, Inc. | Clinic/Center | 205 N. East Ave, 7th Fl One Jackson Square, Jackson, MI 49201 | 2006-09-29 |
| 1528620366 | Maha Mahesh Bayya | Student in an Organized Health Care Education/Training Program | 205 N. East Ave, Gme - 2nd Floor Cab, Jackson, MI 49201-1753 | 2019-07-02 |
| 1558856187 | Narine Shirvanian | Student in an Organized Health Care Education/Training Program | 205 N. East Ave, 2nd Floor Anderson Building, Jackson, MI 49201 | 2018-06-26 |
| 1255861241 | Michael Doyle | Student in an Organized Health Care Education/Training Program | 205 N. East Ave, Jackson, MI 49201 | 2017-06-13 |
| 1073051199 | W.a. Foote Memorial Hospital, Inc | Hospitalist | 205 N. East Ave, Attn: Provider Enrollment, Jackson, MI 49201 | 2017-02-09 |
| 1134666936 | W.a. Foote Memorial Hospital, Inc | Dermatology | 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 |
| 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 | 2084P0800X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Psychiatry |
| A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871932194 | Saurabh Bipin Bhardwaj | Psychiatry & Neurology | 2500 N State St # H814, Jackson, MS 39216-4500 | 2013-06-19 |
| 1548421795 | Edgar Draper | Psychiatry & Neurology | 2419 Lake Circle, Jackson, MS 39211 | 2008-06-20 |
| 1689854523 | Robert J Brock Md PC | Psychiatry & Neurology | 480 S Cache, Jackson, WY 83001-0941 | 2007-11-08 |
| 1821285610 | Michaela Puno Weller | Psychiatry & Neurology | 3855 Cooper St, Charles Egeler Reception & Guidance Center, Jackson, MI 49201-7547 | 2007-09-26 |
| 1285846774 | Debra E Rodgers Md Pa | Psychiatry & Neurology | 175 Olympia Flds, Jackson, MS 39211-2510 | 2007-05-04 |
| 1497808463 | Virginia J Payne | Psychiatry & Neurology | 1675 Lakeland Dr Ste 200, Jackson, MS 39216-4843 | 2007-01-20 |
| 1952453854 | Marcelita A Bermudez | Psychiatry & Neurology | 4502 Hwy 951, Jackson, LA 70748 | 2007-01-18 |
| 1225180938 | Joe C Scoggin Sr. | Psychiatry & Neurology | 1675 Lakeland Drive, 200 Riverhill Tower, Jackson, MS 39216-4852 | 2007-01-16 |
| 1649352337 | Michael E Stept | Psychiatry & Neurology | 1675 Lakeland Dr, Ste 200, Jackson, MS 39216-4843 | 2006-10-20 |
| 1881702710 | Andrew Charles Bishop | Psychiatry & Neurology | 971 Lakeland Dr Ste 654, Jackson, MS 39216-4605 | 2006-08-29 |
| 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.