W.A. FOOTE MEMORIAL HOSPITAL, INC (NPI# 1235676180) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235676180 |
| 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 | 2017-01-30 |
| Last Update Date | 2017-03-02 |
| 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 | 363A00000X | Physician Assistant | 1060000044 | MI | Physician Assistants & Advanced Practice Nursing Providers |
| 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 |
| 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 |
| 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 |
| 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 |
| 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 |
| 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 |
| 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 | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942834494 | Emily Amburn | Physician Assistant | 2968 N Highland Ave, Jackson, TN 38305-3409 | 2020-02-24 |
| 1982234183 | Eva Mackenzie Carmody | Physician Assistant | 1190 N State St Suite 502, Jackson, MS 39202 | 2020-01-16 |
| 1972161891 | Allison Taylor | Physician Assistant | 1850 Chadwick Drive, Suite 1427, North Tower, 4 West, Jackson, MS 39204-3404 | 2019-06-05 |
| 1306302328 | Chloe A Goldfarb | Physician Assistant | 21 Shoal Rd, Jackson, NJ 08527-4025 | 2019-02-14 |
| 1447722558 | Casey James Elliott | Physician Assistant | 747 Oakwood St, Jackson, MS 39202-1121 | 2018-12-31 |
| 1700372109 | Chad Zawacki | Physician Assistant | 147 North Star Drive, Jackson, TN 38305 | 2018-07-09 |
| 1982194551 | Samantha Lynn Denoville | Physician Assistant | 1 Kensington Ct, Jackson, NJ 08527-1292 | 2018-05-18 |
| 1104320308 | Dalton Glenn Weaver | Physician Assistant | 708 N Highland Ave, Jackson, TN 38301-4829 | 2018-03-21 |
| 1336669258 | Whitney J Peterson | Physician Assistant | 501 Marshall St Ste 301, Jackson, MS 39202-1687 | 2017-06-21 |
| 1922541093 | Jacob Carpenter | Physician Assistant | 2497 N West St, Jackson, MS 39216-4409 | 2016-11-22 |
| 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.