NPIMap

Organization Active NPI

W.a. Foote Memorial Hospital

Doing business as Allegiance Health

  • Psychiatry Physician
  • Jackson, MI
National Provider Identifier
1073547964
Registry record updated Oct 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
W.A. FOOTE MEMORIAL HOSPITAL
Doing business as
Allegiance Health
Henry Ford Jackson Health
Practice address
205 N East Ave
Jackson, MI 49201-1753
Phone
(517) 788-4800
NPI assigned
Jul 10, 2006
Last updated
Oct 22, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Kimberly Cebalt
Title
Director
Phone
(313) 874-6764

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X MI
Social Worker 104100000X MI
Psychiatry Physician 2084P0800X MI Primary

Addresses

Primary practice location

205 N East Ave
Jackson, MI 49201-1753

Mailing address

PO Box 670884
Detroit, MI 48267-2728
Phone (800) 999-5829

Other identifiers 4

IdentifierTypeStateIssuer
260C863890OtherMIBCBSM
680C810300OtherMIBCBSM
750910501/800C810270OtherMIBCBSM LMSW/LLMSW
CC5829OtherMIRR MEDICARE

Other names 2

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

National Provider Directory

National Provider Directory
Part of
Jackson Speech and Hear

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1792627200000",
    "number": "1073547964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 670884",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482672728",
            "telephone_number": "800-999-5829",
            "fax_number": "248-641-4840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 N EAST AVE",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492011753",
            "telephone_number": "517-788-4800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "W.A. FOOTE MEMORIAL HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-10",
        "last_updated": "2026-10-22",
        "certification_date": "2026-10-22",
        "status": "A",
        "authorized_official_last_name": "CEBALT",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "313-874-6764"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM",
            "identifier": "260C863890",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM",
            "identifier": "680C810300",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM LMSW/LLMSW",
            "identifier": "750910501/800C810270",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "CC5829",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Allegiance Health",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Allegiance Health",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Henry Ford Jackson Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Jackson, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.