Wa Foote Memorial Hospital

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

WA FOOTE MEMORIAL HOSPITAL

Practice address

205 N East Ave
Jackson, MI 49201-1753

Phone

(517) 788-4800

NPI assigned

Sep 8, 2006

Last updated

Aug 9, 2019By 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, MD

Title

SVP - Cmo, Ceo - Hfamg

Phone

(517) 205-6407

Specialties & licenses 1

Addresses

Other names 1

• ON HOLD Other name

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Part of

Foote HLTH Ctr Pha

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

Practitioners 2

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.

• Brian James Daly, MD

  • Surgery Physician
  • Jackson, MI
  • NPI 1790824225
  NPD
• John Joseph Wald, M.D.

  • Neurology Physician
  • Jackson, MI
  • NPI 1275627366
  NPD

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

{
    "created_epoch": "1157673600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1565308800000",
    "number": "1861596124",
    "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": "2006-09-08",
        "last_updated": "2019-08-09",
        "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_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "MI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ON HOLD",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "ON HOLD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• 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
• 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)

• Primary Care Clinic/Center in Jackson, MI
• Providers in Jackson, MI by specialty
• Primary Care Clinic/Center in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2019; 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.