Wa Foote Memorial Hospital Inc.

Primary specialty

Registered DietitianTaxonomy code 133V00000X

Legal business name

WA FOOTE MEMORIAL HOSPITAL INC.

Doing business as

Henry Ford Allegiance Health

Practice address

205 N East Ave
Jackson, MI 49201-1753

Phone

(517) 841-7878

Fax

(517) 817-7664

NPI assigned

Jul 19, 2013

Last updated

Mar 6, 2024By the provider in NPPES

Organization subpart

Yes

Parent organization

WA FOOTE MEMOIRAL HOSPITAL INC.As reported in NPPES

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

Authorized official

Name

Mark Smith

Title

SVP. Cmo

Phone

(517) 205-6407

Specialties & licenses 1

Addresses

Other names 1

• Henry Ford Allegiance Health Doing business as

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Part of

Jackson Speech and Hear

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

{
    "created_epoch": "1374192000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709683200000",
    "number": "1073955050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 N EAST AVE",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492011753",
            "telephone_number": "517-841-7482",
            "fax_number": "517-841-7476"
        },
        {
            "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": "517-841-7878",
            "fax_number": "517-817-7664"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WA FOOTE MEMORIAL HOSPITAL INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WA FOOTE MEMOIRAL HOSPITAL INC.",
        "enumeration_date": "2013-07-19",
        "last_updated": "2024-03-06",
        "certification_date": "2024-03-06",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "SVP. CMO",
        "authorized_official_telephone_number": "517-205-6407"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "MI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Henry Ford Allegiance Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Wa Foote Memorial Hospital
• Wa Foote Memorial Hospital
• Wa Foote Memorial Hospital (On Hold)
• Wa Foote Memorial Hospital Inc (Henry Ford Allegiance Health)
• Wa Foote Memorial Hospital Inc (Henry Ford Allegiance Health)
• Wa Foote Memorial Hospital Inc. (Henry Ford Allegiance Health)
• Wa Foote Memorial Hospital Inc. (Henry Ford Alleginace Health)
• Wa Foote Memorial Hospital Inc. (Henry Ford Allegiance Health)
• Wa Foote Memorial Hospital, Inc (Allegiance Health)
• Wa Foote Memorial Hospital, Inc (Allegiance Health)

• Registered Dietitian in Jackson, MI
• Providers in Jackson, MI by specialty
• Registered Dietitian in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.