NPIMap

Organization Active NPI

Carelink of Jackson, a Community-Owned Specialty Hospital

  • Long Term Care Hospital
  • Jackson, MI
National Provider Identifier
1073588034
Registry record updated Aug 1, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care HospitalTaxonomy code 282E00000X
License
380051 Issued in MI
Legal business name
CARELINK OF JACKSON, A COMMUNITY-OWNED SPECIALTY HOSPITAL
Practice address
110 N. Elm Avenue
Jackson, MI 49202-3595
Phone
(517) 796-4475
Fax
(517) 787-5226
NPI assigned
Feb 22, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2019

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

Authorized official

Name
Ms. Mark Smith
Title
SVP - Cmo, Ceo - Hfamg
Phone
(517) 205-6407

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Long Term Care Hospital 282E00000X 380051 MI Primary
General Acute Care Hospital 282N00000X

Addresses

Primary practice location

110 N. Elm Avenue
Jackson, MI 49202-3595

Mailing address

110 N. Elm Avenue
Jackson, MI 49202-3595
Phone (517) 796-4475

Other identifiers 3

IdentifierTypeStateIssuer
1556625MedicaidMI
17008OtherMIBLUE CROSS
7188892OtherMIPHYSICIANS HEALTH PLAN

Other names 2

  • Henry Ford Allegiance CareLink Doing business as
  • Herny Ford Allegiance Specialty Hospital Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

Hospital certification: CCN 230184

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
CARELINK OF JACKSON, A COMMUNITY-OWNED SPECIALTY H
Certification status
Terminated Other: provider status change, Mar 1, 2004
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
Oct 6, 1988
Beds
67
Ownership / control type
Other
Facility address
110 N Elm Avenue
Jackson, MI 49202

National Provider Directory

National Provider Directory

Member of 1

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

NPI Registry JSON

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

{
    "created_epoch": "1140566400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1564617600000",
    "number": "1073588034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 N. ELM AVENUE",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492023595",
            "telephone_number": "517-796-4475",
            "fax_number": "517-787-5226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 N. ELM AVENUE",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492023595",
            "telephone_number": "517-796-4475",
            "fax_number": "517-787-5226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARELINK OF JACKSON, A COMMUNITY-OWNED SPECIALTY HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-22",
        "last_updated": "2019-08-01",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "SVP - CMO, CEO - HFAMG",
        "authorized_official_telephone_number": "517-205-6407",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "282E00000X",
            "taxonomy_group": "",
            "desc": "Long Term Care Hospital",
            "state": "MI",
            "license": "380051",
            "primary": true
        },
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1556625",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "17008",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICIANS HEALTH PLAN",
            "identifier": "7188892",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Henry Ford Allegiance CareLink",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Herny Ford Allegiance Specialty Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Jackson, MI

Sources for this page

Verify at the official NPI Registry.