W.a. Foote Memorial Hospital
Organization Active NPI Psychiatric Hospital Unit · Jackson, MI
NPI 1962594317 · NPPES record last updated Jan 7, 2026
Key facts
- NPI
- 1962594317
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Psychiatric Hospital Unit 273R00000X
- Legal business name
- W.A. FOOTE MEMORIAL HOSPITAL
- Practice address
- 205 N East Ave
7TH FL One Jackson Square
Jackson, MI 49201 - Phone
- (517) 788-4713
- Fax
- (517) 841-7419
- NPI assigned
- Sep 29, 2006
- Organization subpart
- Yes
- Parent organization (as reported)
- W.A. FOOTE MEMORIAL HOSPITAL
Authorized official
- Name
- Robin S. Damschroder, MD
- Title
- Evp, Chief Fin & Bus Dev Officer
- Phone
- (313) 876-8452
Owners & managing parties with NPI records 2
-
Farzan Siddiqui, M.D., PH.D.
-
Lisa Fitzpatrick, MD, MPH
Other NPIs with the same Medicare PAC ID 10
Corporate family (same tax ID) 16
Member of 1
Related certifications (CCN) 1
Facilities with the same owner 159
Practitioners 477
-
Iman S Abou-Chakra, M.D.
-
Hiba Abu Suhaiban, M.D
-
Christine Rima Acho, M.P.H, D.O.
-
Abdullah Adnan, D.O
-
Masood Ahmad, M.D.
-
Amanda Ahrens, CRNA
-
Fadi Alali, M.D
-
William H. Alarcon, M.D.
-
Maureen Therese Albe, PA-C
-
Ronda Kay Albrecht, M.S.N., ACNP-BC
-
Husam Alghanem, M.D.
-
Syed Ahmed Ali, MD
-
Khaled Almadhoun, DO
-
Reem Jurjis Alsabti, M.D.
-
Mahir H Alsalman, M.D.
-
Rami Alzebdeh, M.D.
-
Shoshana Woo Ambani, M.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
Hospital certification: CCN 23S092
- Legal name
- W. A. FOOTE MEMORIAL HOSPITAL, INC.
- Doing business as
- HENRY FORD HEALTH JACKSON HOSPITAL
- Organization structure
- Corporation · Non-profit
- Enrollment address
- 205 N East Ave
Jackson, MI 49201-1753 - Hospital subgroups
- Psychiatric unit
All disclosed owners & managing parties 33
| Name | Role | Since | Share |
|---|---|---|---|
| Daniel J. Phelan |
Corporate Director |
Jan 1, 2022 | |
| Michael a. Grisdela |
W-2 Managing Employee |
Feb 1, 2025 | |
| Henry Ford Health System |
5% Or Greater Indirect Ownership Interest | Apr 1, 2016 | 100% |
| Charles McClure |
Corporate Director |
Jul 25, 2014 | |
| Robert R Lubera |
Corporate Director |
Sep 1, 2025 | |
| Frederiek Toney |
Corporate Director |
Jan 1, 2021 | |
| Barry G. Porter |
Corporate Director |
Jan 1, 2020 | |
| Steven Brian Bender |
Corporate Officer |
Oct 21, 2024 | |
| Gerardo Norcia |
Corporate Director |
Dec 1, 2023 | |
| Robert Riney |
Corporate Director |
Apr 1, 2016 | |
| Michael Rafferty |
Corporate Director |
Jan 1, 2020 | |
| Jeffrey Fall |
Corporate Director |
Sep 1, 2025 | |
| Farzan Siddiqui |
Corporate Director |
Jan 1, 2024 | |
| Marjorie Staten |
Corporate Officer |
Jan 1, 2019 | |
| Rhonda M Medows |
Corporate Director |
Sep 1, 2025 | |
| David Breen |
Corporate Officer |
Jan 1, 2016 | |
| Corporate Director |
Jan 1, 2015 | ||
| Mary Ann Victor |
Corporate Director |
Sep 1, 2025 | |
| Jason Williams |
W-2 Managing Employee | Oct 1, 2024 | |
| Anthony Rocco Tersigni |
Corporate Director |
Oct 1, 2024 | |
| Robin S. Damschroder |
Corporate Officer |
Jan 1, 2018 | |
| Calvin R Ford |
Corporate Director |
Jan 1, 2025 | |
| Gregory Pflum |
Corporate Director |
Sep 1, 2025 | |
| Henry Ford Allegiance Health Group |
5% Or Greater Direct Ownership Interest | Apr 1, 2016 | 100% |
| Henry Ford Health Parent |
5% Or Greater Indirect Ownership Interest | Oct 1, 2024 | 80% |
| Edward D Callaghan |
Corporate Director |
Sep 1, 2025 | |
| John F. Harris |
Corporate Director |
Jan 1, 2021 | |
| Ascension Health |
5% Or Greater Indirect Ownership Interest | Oct 1, 2024 | 20% |
| Edgar Vann |
Corporate Director |
Jan 1, 2015 | |
| Lisa Fitzpatrick |
Corporate Director |
Sep 1, 2025 | |
| Joseph Richardson |
Corporate Director |
Jan 1, 2016 | |
| Gwendolyn M Mackenzie |
Corporate Director |
Sep 1, 2025 | |
| Jacalyn S. Goforth |
Corporate Director |
Jan 1, 2022 | |
| Eugene F Lovasco |
Corporate Director |
Oct 1, 2024 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20090204000092 | MI | Part a Provider - Hospital | 0244136067 | Practice locations: Jackson, MI |
National Provider Directory
- Tax ID family
- Foote Emerg Phys
- Part of
- Foote Emerg Phys
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric Hospital Unit | 273R00000X | Yes |
Addresses
Primary practice location
205 N East Ave
7TH FL One Jackson Square
Jackson, MI 49201
Mailing address
205 N East Ave
7TH FL One Jackson Square
Jackson, MI 49201
Phone (517) 788-4713
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 045908 | Other | MA | HEALTH ALLIANCE PLAN |
| HL380002 | Other | MI | MCARE |
| 5020010 | Other | MI | PHYSICIAN'S HEALTH PLAN |
| 00080 | Other | MI | BLUE CARE NETWORK |
| 092063100 | Medicaid | FL | |
| 2855754 | Medicaid | MI | |
| 030066700 | Other | MA | UNITED MINE WORKERS |
| P100094 | Other | MI | PREFERRED CARE CHOICES |
| 01410125 | Medicaid | KY | |
| 100094 | Other | MI | PREFERRED CHOICES |
| 00080 | Other | MI | BLUE CROSS OF MICHIGAN |
Other names
- Henry Ford Allegiance Health
- Henry Ford Health Jackson Hospital
Other providers in Jackson, MI
- W. a. Foote Memorial Hospital, Inc.
- W.a. Foote Memorial Hospital
- W.a. Foote Memorial Hospital
- W.a. Foote Memorial Hospital
- W.a. Foote Memorial Hospital
- W.a. Foote Memorial Hospital, Inc
- W.a. Foote Memorial Hospital, Inc
- W.a. Foote Memorial Hospital, Inc
- W.a. Foote Memorial Hospital, Inc
- W.a. Foote Memorial Hospital, Inc
All providers in Jackson, MI · Psychiatric Hospital Unit in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 7, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.