W. A. FOOTE MEMORIAL HOSPITAL, INC (NPI# 1942740311) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1942740311 |
| 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 | 2017-03-03 |
| Last Update Date | 2017-03-03 |
| 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 | 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 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 |
|---|---|---|---|---|
| 1093210551 | W. A. Foote Memorial Hospital, Inc | Clinic/Center | 2424 W Washington Ave Ste 100, Jackson, MI 49203-1236 | 2018-03-27 |
| 1699279570 | W. A. Foote Memorial Hospital, Inc | Clinical Medical Laboratory | 153 Wamplers Lake Rd, Brooklyn, MI 49230-9585 | 2018-03-23 |
| 1073017935 | W. A. Foote Memorial Hospital, Inc | Clinic/Center | 1100 E Michigan Ave Ste 102, Jackson, MI 49201-1800 | 2018-03-23 |
| 1750885703 | W. A. Foote Memorial Hospital, Inc | Substance Abuse Rehabilitation Facility | 2424 W Washington Ave Ste 200, Jackson, MI 49203-1236 | 2018-03-22 |
| 1831694371 | W. A. Foote Memorial Hospital, Inc | Clinic/Center | 205 N East Ave, Jackson, MI 49201-1753 | 2018-03-27 |
| 1073018511 | W. A. Foote Memorial Hospital, Inc | Clinic/Center | 4304 Page Ave Ste 100, Michigan Center, MI 49254-1078 | 2018-03-27 |
| 1386149979 | W. A. Foote Memorial Hospital, Inc | Clinic/Center | 205 S East Ave, Jackson, MI 49201-2413 | 2018-03-27 |
| 1740785328 | W. A. Foote Memorial Hospital, Inc | Clinic/Center | 4400 Ann Arbor Rd, Jackson, MI 49202-2814 | 2018-03-27 |
| 1023513603 | W. A. Foote Memorial Hospital, Inc | Clinical Medical Laboratory | 400 Hinckley Blvd, Jackson, MI 49203-6152 | 2018-03-27 |
| 1972008415 | W. A. Foote Memorial Hospital, Inc | Clinic/Center | 1201 E Michigan Ave Ste 300, Jackson, MI 49201-1853 | 2018-03-27 |
| 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 | 208G00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Thoracic Surgery (Cardiothoracic Vascular Surgery) |
| A thoracic surgeon provides the operative, perioperative and critical care of patients with pathologic conditions within the chest. Included is the surgical care of coronary artery disease, cancers of the lung, esophagus and chest wall, abnormalities of the trachea, abnormalities of the great vessels and heart valves, congenital anomalies, tumors of the mediastinum and diseases of the diaphragm. The management of the airway and injuries of the chest is within the scope of the specialty. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Thoracic Surgery, 2007. http://www.abts.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Thoracic Surgery. Thoracic surgeons have the knowledge, experience and technical skills to accurately diagnose, operate upon safely, and effectively manage patients with thoracic diseases of the chest. This requires substantial knowledge of cardiorespiratory physiology and oncology, as well as capability in the use of heart assist devices, management of abnormal heart rhythms and drainage of the chest cavity, respiratory support systems, endoscopy and invasive and noninvasive diagnostic techniques. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720258734 | Jacob Jerome Cohen | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 63 Colchester Dr, Jackson, NJ 08527-4782 | 2008-03-05 |
| 1841498656 | Kenneth Marc Begelman | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 400 Moulton Loop, Jackson, WY 83001-0764 | 2007-07-03 |
| 1275581720 | Douglas C. Appleby Jr. | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 329 Coatsland Dr, Jackson, TN 38301-3912 | 2006-05-05 |
| 1639176472 | Vern Antoine Keller | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 971 Lakeland Dr Ste 657, Jackson, MS 39216-4608 | 2005-07-07 |
| 1134462849 | Ali Dodge-khatami | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 2500 N State St, Division of Pediatric Cardiac Surgery, Jackson, MS 39216-4500 | 2013-04-01 |
| 1306077672 | Robert B Lee Md Pllc | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 1860 Chadwick Dr, Suite 352, Jackson, MS 39204-3463 | 2009-08-04 |
| 1538396056 | St. Dominic Medical Associates Inc | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 971 Lakeland Dr, Suite 1159, Jackson, MS 39216-4643 | 2009-06-11 |
| 1972743797 | Jacob Moremen | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 2500 North State Street, Jackson, MS 39216-4500 | 2009-03-06 |
| 1831342054 | St Dominic Medical Associates LLC | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 970 Lakeland Dr Ste 61, Jackson, MS 39216-4634 | 2008-10-31 |
| 1598947145 | Thomas L Kilgore | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 1225 N State St, Jackson, MS 39202-2064 | 2007-12-05 |
| 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.