W.a. Foote Memorial Hospital

Organization Active NPI General Acute Care Hospital · Jackson, MI

NPI 1053403402 · NPPES record last updated Jan 7, 2026

Key facts

NPI
1053403402
Entity type
Organization (NPI type 2)
Primary specialty
General Acute Care Hospital 282N00000X
Legal business name
W.A. FOOTE MEMORIAL HOSPITAL
Practice address
205 N East Ave
Jackson, MI 49201-1753
Phone
(517) 205-4800
Fax
(517) 205-7419
NPI assigned
Sep 29, 2006
Organization subpart
No

Authorized official

Name
Robin S. Damschroder
Title
Evp, Chief Fin & Bus Dev Officer
Phone
(313) 876-8452

Owners & managing parties with NPI records 2

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Other NPIs with the same Medicare PAC ID 10

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Corporate family (same tax ID) 16

Organizations that report the same tax identification number in the National Provider Directory.

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Facilities connected through Provider of Services related, parent or unit certification numbers.

Facilities with the same owner 159

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 159

Practitioners 521

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 521

Affiliated clinicians 843

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 843

Medicare Care Compare: Hospital

Listed as
Henry Ford Allegiance Health CCN 230092
Overall star rating
★★★☆☆ 3 of 5
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Other
Medicare certification status
Active (Provider of Services file)
Emergency services
Yes

Source: Medicare Care Compare.

Medicare participation

Medicare fee-for-service enrollment
Enrolled (2 enrollments) in MI

Hospital certification: CCN 230092

Legal name
W. A. FOOTE MEMORIAL HOSPITAL, INC.
Doing business as
HENRY FORD HEALTH JACKSON HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
Aug 3, 2011
Beds
412
Ownership / control type
Other
Organization structure
Corporation · Non-profit
Enrollment address
205 N East Ave
Jackson, MI 49201-1753
Main/Primary Hospital Location
Hospital subgroups
Acute care

All disclosed owners & managing parties 33

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Daniel J. Phelan
Individual
Corporate Officer
Board Member
Jan 1, 2022
Michael a. Grisdela
Individual
W-2 Managing Employee
Associate Cfo
Feb 1, 2025
Henry Ford Health System
Organization · Troy, MI
Corporation, Non-profit, Chain home office
5% Or Greater Indirect Ownership Interest Apr 1, 2016 100%
Charles McClure
Individual
Corporate Director
Board Member
Apr 1, 2016
Robert R Lubera
Individual
Corporate Director
Board Member
Sep 1, 2025
Frederiek Toney
Individual
Corporate Director
Board Member
Jan 1, 2021
Barry G. Porter
Individual
Corporate Director
Board Member
Jan 1, 2020
Steven Brian Bender
Individual
Corporate Officer
Secretary
Oct 21, 2024
Gerardo Norcia
Individual
Corporate Director
Board Member
Dec 1, 2023
Robert Riney
Individual
Corporate Director
Board Member
Apr 1, 2016
Michael Rafferty
Individual
Corporate Director
Board Member
Jan 1, 2020
Jeffrey Fall
Individual
Corporate Director
Board Member
Sep 1, 2025
Farzan Siddiqui
Individual
Corporate Director
Board Member
Jan 1, 2024
Marjorie Staten
Individual
Corporate Director
Board Member
Jan 1, 2019
Rhonda M Medows
Individual
Corporate Director
Board Member
Sep 1, 2025
David Breen
Individual
Corporate Officer
Vice Chair
Apr 1, 2016
Corporate Director
Board Member
Apr 1, 2016
Mary Ann Victor
Individual
Corporate Director
Board Member
Sep 1, 2025
Jason Williams
Individual
W-2 Managing Employee
VP Contracting Reimb Rev Int
Oct 1, 2024
Anthony Rocco Tersigni
Individual
Corporate Director
Board Member
Oct 1, 2024
Robin S. Damschroder
Individual
Corporate Officer
President, Val Based ENT &Cfo
Jan 1, 2018
Calvin R Ford
Individual
Corporate Director
Board Member
Jan 1, 2025
Gregory Pflum
Individual
Corporate Director
Board Member
Sep 1, 2025
Henry Ford Allegiance Health Group
Organization · Jackson, MI
Corporation, Non-profit
5% Or Greater Direct Ownership Interest Apr 1, 2016 100%
Henry Ford Health Parent
Organization · Detroit, MI
Created for acquisition, Corporation, Non-profit
5% Or Greater Indirect Ownership Interest Oct 1, 2024 80%
Edward D Callaghan
Individual
Corporate Director
Board Member
Sep 1, 2025
John F. Harris
Individual
Corporate Director
Board Member
Jan 1, 2021
Ascension Health
Organization · Saint Louis, MO
Corporation, Non-profit
5% Or Greater Indirect Ownership Interest Oct 1, 2024 20%
Edgar Vann
Individual
Corporate Director
Board Member
Apr 1, 2016
Lisa Fitzpatrick
Individual
Corporate Director
Board Member
Sep 1, 2025
Joseph Richardson
Individual
Corporate Director
Board Member
Apr 1, 2016
Gwendolyn M Mackenzie
Individual
Corporate Director
Board Member
Sep 1, 2025
Jacalyn S. Goforth
Individual
Corporate Director
Board Member
Jan 1, 2022
Eugene F Lovasco
Individual
Corporate Director
Board Member
Oct 1, 2024

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20031215000361 MI Part B Supplier - Clinic/Group Practice 0244136067 Receives reassigned benefits from 36 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Jackson, MI
O20090203000500 MI Part a Provider - Hospital 0244136067

National Provider Directory

Tax ID family
Foote Emerg Phys (104 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X Yes

Addresses

Primary practice location

205 N East Ave
Jackson, MI 49201-1753

Mailing address

205 N East Ave
Jackson, MI 49201-1753
Phone (517) 788-4800

Other identifiers

IdentifierTypeStateIssuer
00080OtherMIBLUE CROSS OF MICHIGAN
045908OtherMIHEALTH ALLIANCE PLAN
00080OtherMIBLUE CARE NETWORK
5020010OtherMIPHYSICIAN'S HEALTH PLAN
P100094OtherMIPREFERRED CARE CHOICES
301556349MedicaidMI
HL380002OtherMIMCARE
030066700OtherMAUNITED MINE WORKERS
100094OtherMIPREFERRED CHOICES
100442MedicaidMI

Other names

  • Henry Ford Allegiance Health Doing business as
  • Henry Ford Health Jackson Hospital Doing business as

Other providers in Jackson, MI

All providers in Jackson, MI · General Acute Care Hospital in Michigan

Sources for this page

Verify at the official NPI Registry.