NPIMap

Organization Active NPI

W a Foote Memorial Hospital Inc

Doing business as HFAH Free Standing Clinic

  • Infusion Therapy Registered Nurse
  • Jackson, MI
National Provider Identifier
1639684137
Registry record updated Apr 23, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infusion Therapy Registered NurseTaxonomy code 163WI0500X
License
106000004 Issued in MI
Legal business name
W A FOOTE MEMORIAL HOSPITAL INC
Doing business as
HFAH Free Standing Clinic
Practice address
205 N East Ave
Jackson, MI 49201-1753
Phone
(517) 205-4922
Fax
(517) 205-6499
NPI assigned
Dec 6, 2017
Last updated
Apr 23, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2018

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

Authorized official

Name
Kevin Leonard
Title
VP Finance
Phone
(517) 205-7410

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Infusion Therapy Registered NurseGroup: 193400000X SINGLE SPECIALTY GROUP 163WI0500X 106000004 MI Primary

Addresses

Primary practice location

205 N East Ave
Jackson, MI 49201-1753

Mailing address

PO Box 67000 Dept 272801
Detroit, MI 48267-2728
Phone (517) 205-7843

Other identifiers 1

IdentifierTypeStateIssuer
1053403402MedicaidMI

Other names 1

  • HFAH Free Standing Clinic Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Jackson Speech and Hear104 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Practitioners & affiliated clinicians

Practitioners 1

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": "1512518400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1524441600000",
    "number": "1639684137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 67000 DEPT 272801",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482672728",
            "telephone_number": "517-205-7843",
            "fax_number": "517-205-7419"
        },
        {
            "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": "517-205-4922",
            "fax_number": "517-205-6499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "W A FOOTE MEMORIAL HOSPITAL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-12-06",
        "last_updated": "2018-04-23",
        "status": "A",
        "authorized_official_last_name": "LEONARD",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_title_or_position": "VP FINANCE",
        "authorized_official_telephone_number": "517-205-7410"
    },
    "taxonomies": [
        {
            "code": "163WI0500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Registered Nurse, Infusion Therapy",
            "state": "MI",
            "license": "106000004",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1053403402",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "HFAH Free Standing Clinic",
            "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 Apr 23, 2018; 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.