Wa Foote Memorial Hospital

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

WA FOOTE MEMORIAL HOSPITAL

Practice address

205 N East Ave
Jackson, MI 49201-1753

Phone

(517) 788-4800

NPI assigned

Apr 2, 2007

Last updated

Mar 6, 2024By the provider in NPPES

Organization subpart

Yes

Parent organization

WA FOOTE MEMORIAL HOSPITALAs reported in NPPES

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

Authorized official

Name

Mark Smith, CFO

Title

SVP. Cmo

Phone

(517) 205-6407

Specialties & licenses 3

Addresses

Other names 1

• ON HOLD Other name

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Part of

Jackson Speech and Hear

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.

• Wa Foote Memorial Hospital

  dba Henry Ford Allegiance Health

  • General Acute Care Hospital
  • Jackson, MI
  • NPI 1285786434
  NPPES parent name

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

{
    "created_epoch": "1175472000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709683200000",
    "number": "1174644058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 67000",
            "address_2": "DEPARTMENT 272801",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482672728",
            "telephone_number": "517-841-6913",
            "fax_number": "517-841-6917"
        },
        {
            "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": "WA FOOTE MEMORIAL HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WA FOOTE MEMORIAL HOSPITAL",
        "enumeration_date": "2007-04-02",
        "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",
        "authorized_official_credential": "CFO"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ON HOLD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• W.a. Foote Memorial Hospital, Inc. (Allegiance Health Pharmacy #7369)
• W.a. Foote Memorial Hospital, Inc. (Henry Ford Allegiance Digestive Health)
• W.a. Foote Memorial Hospital, Inc. (Allegiance Personal Care Services)
• W.a. Foote Memorial Hospital, Inc. (Henry Ford Allegiance Health)
• Wa Foote Memorial Hospital
• Wa Foote Memorial Hospital (Henry Ford Allegiance Health)
• Wa Foote Memorial Hospital
• Wa Foote Memorial Hospital (Henry Ford Allegiance Health)
• Wa Foote Memorial Hospital
• Wa Foote Memorial Hospital

• Internal Medicine Physician in Jackson, MI
• Providers in Jackson, MI by specialty
• Internal Medicine Physician 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.