WA FOOTE MEMORIAL HOSPITAL, INC


Address: 205 N East Ave, Jackson, MI 49201-1753
Phone: 5177884800

WA FOOTE MEMORIAL HOSPITAL, INC (NPI# 1891965943) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1891965943
Entity Type Organization
Organization Name WA FOOTE MEMORIAL HOSPITAL, INC
Other Organization Name 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 5177884800
Mailing Telephone 5178416913
Mailing Fax Number 5178416917
Enumeration Date 2008-03-05
Last Update Date 2008-08-04
Authorized Official Name JEANNE' WICKENS (SR VP FINANCE/CFO)
Authorized Official Telephone 5177884883
Is Organization Subpart Y
Parent Organization Name WA FOOTE MEMORIAL HOSPITAL, INC

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 261QU0200X Clinic/Center
Specialization: Urgent Care
MI Ambulatory Health Care Facilities
Y 207P00000X Emergency Medicine MI Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
MI BCN 700C810750 01

Other Provider/Organization Names

Other Name Type Code
Allegiance Health Doing Business As Name - Organization

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
1083884126 Wa Foote Memorial Hospital, Inc Clinic/Center 205 N East Ave, Jackson, MI 49201-1753 2008-03-05
1598776718 Wa Foote Memorial Hospital, Inc Nurse Anesthetist, Certified Registered 205 N East Ave, Crna, Jackson, MI 49201-1753 2006-08-11
1336165455 Wa Foote Memorial Hospital, Inc Physician Assistant 205 N East Ave, Jackson, MI 49201-1753 2006-07-14
1124052279 Wa Foote Memorial Hospital, Inc Advanced Practice Midwife 205 N East Ave, Jackson, MI 49201-1753 2006-07-11
1811921968 Wa Foote Memorial Hospital, Inc Otolaryngology 205 N East Ave, Jackson, MI 49201-1753 2006-07-11
1073547964 Wa Foote Memorial Hospital, Inc Psychologist 205 N East Ave, Jackson, MI 49201-1753 2006-07-10
1831123728 Wa Foote Memorial Hospital, Inc Internal Medicine 205 N East Ave, Jackson, MI 49201-1753 2006-07-10
1629000708 Wa Foote Memorial Hospital, Inc Nurse Practitioner 205 N East Ave, Jackson, MI 49201-1753 2006-07-07
1326078866 Wa Foote Memorial Hospital, Inc Psychologist 205 N East Ave, Jackson, MI 49201-1753 2006-07-03
1215974332 Wa Foote Memorial Hospital, Inc Clinic/Center 205 N East Ave, Jackson, MI 49201-1753 2006-05-31

Office Location

Street Address 205 N EAST AVE
City JACKSON
State MI
Zip Code 49201-1753

Providers in the same location

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
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Providers in the same zip code

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
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Taxonomy Information

Taxonomy Code 207P00000X
Grouping Allopathic & Osteopathic Physicians
Classification Emergency Medicine

Taxonomy Definition

An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: mofified source]
- Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/; American Osteopathic Board of Emergency Medicine, 2007. http://www.osteopathic.org/certification
- Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Emergency Medicine.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1891141032 Tobin S Dennis Emergency Medicine 625 East Broadway Ave, Jackson, WY 83001-8642 2016-05-06
1902270093 Steven Pirtle French Emergency Medicine 6605 N Snake River Woods Dr, Jackson, WY 83001-8491 2015-11-30
1942612015 Emergency Associates Pllc Emergency Medicine 2660 Ridgewood Rd, Suite 100, Jackson, MS 39216-4921 2014-05-23
1083995674 Obhg Mississippi, P.C. Emergency Medicine 1225 N State St Ste B1, Jackson, MS 39202-2072 2011-09-09
1508180183 Jon Edward Zamber Emergency Medicine 361 Willie Adams Rd, Jackson, TN 38305-7223 2010-03-25
1750510962 Jason Robert Schwanebeck Emergency Medicine University of Missisippi Medical Center, 2500 North State Street, Jackson, MS 39216-4505 2009-07-09
1366629214 Joseph Scott Savage Emergency Medicine 400 N Alpine Lake Dr, Suite F, Jackson, MI 49203-6334 2008-01-23
1689709610 Dawn Nicole Laws Emergency Medicine 1325 N West Ave, Jackson, MI 49202-2050 2007-02-22
1194834747 Joseph W Blackston Emergency Medicine 1900 Petit Bois St N, Jackson, MS 39211-6707 2006-08-29
1174637318 Kaushal Patel Emergency Medicine 205 Trace Dr, Jackson, TN 38305-1580 2006-08-17
Find all providers in JACKSON

Competitor

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City JACKSON
Zip Code 49201

Improve Information

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Dataset Information

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.

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