WA FOOTE MEMORIAL HOSPITAL (NPI# 1982825139) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1982825139 |
| 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 | 2007-05-02 |
| Last Update Date | 2008-05-14 |
| Authorized Official Name | JEANNE' WICKENS (SENIOR VICE PRESIDENT OF FINANCE) |
| Authorized Official Telephone | 5177884883 |
| 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 | 207XP3100X |
Orthopaedic Surgery Specialization: Pediatric Orthopaedic Surgery |
MI | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| ON HOLD | Doing Business As Name - 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 |
| 1457563223 | Wa Foote Memorial Hospital | Clinic/Center | 205 N East Ave, Jackson, MI 49201-1753 | 2007-05-04 |
| 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 | 207XP3100X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| Specialization | Pediatric Orthopaedic Surgery |
| An orthopedic surgeon who has additional training and experience in diagnosing, treating and managing musculoskeletal problems in infants, children and adolescents. These may include limb and spine deformities (such as club foot, scoliosis); gait abnormalities (limping); bone and joint infections; broken bones. |
| Notes: Source: American Academy of Pediatrics, www.aap.org [7/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407312127 | Khristinn Kellie Leitch | Orthopaedic Surgery | 2500 N State St, Jackson, MS 39216-4500 | 2019-02-18 |
| 1255527743 | Patrick Beaumont Wright | Orthopaedic Surgery | 2500 N State St, Department of Orthopedic Surgery and Rehabilitation, Jackson, MS 39216-4500 | 2007-09-19 |
| 1306067277 | Pediatric Orthopaedic Specialists of Mississippi | Orthopaedic Surgery | 1190 N State St, Suite 204, Jackson, MS 39202-2413 | 2007-05-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689962342 | Christopher Minnock | Orthopaedic Surgery | 350 W Big Beaver Rd Dept Of, Troy, MI 48084-5246 | 2011-07-15 |
| 1285854315 | Lanny Leo Johnson | Orthopaedic Surgery | 4658 Chippewa Dr, Okemos, MI 48864-2060 | 2007-04-30 |
| 1215416961 | Spectrum Health Primary Care Partners | Orthopaedic Surgery | 802 W King St, Owosso, MI 48867-2100 | 2018-08-13 |
| 1578839338 | Spectrum Health Primary Care Partners | Orthopaedic Surgery | 2815 S Pennsylvania Ave, Suite 204, Lansing, MI 48910-3495 | 2012-03-27 |
| 1972880920 | Spectrum Health Primary Care Partners | Orthopaedic Surgery | 3950 Hollywood Rd, Suite 240, Saint Joseph, MI 49085-9159 | 2011-11-04 |
| 1396024683 | Spectrum Health Primary Care Partners | Orthopaedic Surgery | 35 Michigan Ne, Grand Rapids, MI 49503 | 2011-08-04 |
| 1558661157 | Spectrum Health Primary Care Partners | Orthopaedic Surgery | 183 Peace Blvd, Saint Joseph, MI 49085-9146 | 2010-10-28 |
| 1477853075 | Spectrum Health Primary Care Partners | Orthopaedic Surgery | 550 Munson Ave, Traverse City, MI 49686-3580 | 2010-10-28 |
| 1760792808 | Spectrum Health Primary Care Partners | Orthopaedic Surgery | 1425 Michigan St Ne, Grand Rapids, MI 49503-2027 | 2010-10-07 |
| 1366608986 | Philip Daniel Nowicki | Orthopaedic Surgery | 35 Michigan St Ne, Suite 4150, Grand Rapids, MI 49503-2514 | 2008-08-04 |
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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.