NPIMap

Organization Active NPI

W.a. Foote Memorial Hospital

Doing business as Henry Ford Allegiance Health

  • Psychiatric Hospital Unit
  • Jackson, MI
National Provider Identifier
1962594317
Registry record updated Jan 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric Hospital UnitTaxonomy code 273R00000X
Legal business name
W.A. FOOTE MEMORIAL HOSPITAL
Doing business as
Henry Ford Allegiance Health
Henry Ford Health Jackson 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
Last updated
Jan 7, 2026By the provider in NPPES
Organization subpart
Yes
Parent organization
W.A. FOOTE MEMORIAL HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 7, 2026

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

Authorized official

Name
Robin S. Damschroder, MD
Title
Evp, Chief Fin & Bus Dev Officer
Phone
(313) 876-8452

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Hospital Unit 273R00000X Primary

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 names 2

  • Henry Ford Allegiance Health Doing business as
  • Henry Ford Health Jackson Hospital Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090204000092 MI Part A Provider - Hospital 0244136067 Practice locations: Jackson, MI

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1962594317. Details of each certification follow.

Hospital certification: CCN 23S092

Legal name
W. A. FOOTE MEMORIAL HOSPITAL, INC.
Doing business as
HENRY FORD HEALTH JACKSON HOSPITAL
Organization structure
CorporationNon-profit
Enrollment address
205 N East Ave
Jackson, MI 49201-1753
Hospital Psychiatric Unit
Hospital subgroups
Psychiatric unit

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 10

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Foote Memorial Physicia104 organizations share this tax ID, including this one
Part of
Foote Memorial Physicia

Organizations with this tax ID in the same state 16

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

View all 16

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 33

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Daniel J. Phelan Individual Corporate DirectorBoard Member Jan 1, 2022
Michael a. Grisdela Individual W-2 Managing EmployeeAssociate Cfo Feb 1, 2025
Henry Ford Health System Organization, Detroit, MI Corporation, Non-profit, Chain home office 5% Or Greater Indirect Ownership Interest Apr 1, 2016 100%
Charles McClure Individual Corporate DirectorBoard Member Jul 25, 2014
Robert R Lubera Individual Corporate DirectorBoard Member Sep 1, 2025
Frederiek Toney Individual Corporate DirectorBoard Member Jan 1, 2021
Barry G. Porter Individual Corporate DirectorBoard Member Jan 1, 2020
Steven Brian Bender Individual Corporate OfficerSecretary Oct 21, 2024
Gerardo Norcia Individual Corporate DirectorBoard Member Dec 1, 2023
Robert Riney Individual Corporate DirectorBoard Member Apr 1, 2016
Michael Rafferty Individual Corporate DirectorBoard Member Jan 1, 2020
Jeffrey Fall Individual Corporate DirectorBoard Member Sep 1, 2025
Farzan Siddiqui Individual Corporate DirectorBoard Member Jan 1, 2024
Marjorie Staten Individual Corporate OfficerBoard Member Jan 1, 2019
Rhonda M Medows Individual Corporate DirectorBoard Member Sep 1, 2025
David Breen Individual Corporate OfficerVice Chair Jan 1, 2016
Corporate DirectorBoard Member Jan 1, 2015
Mary Ann Victor Individual Corporate DirectorBoard Member Sep 1, 2025
Jason Williams Individual W-2 Managing Employee Oct 1, 2024
Anthony Rocco Tersigni Individual Corporate DirectorBoard Member Oct 1, 2024
Robin S. Damschroder Individual Corporate OfficerPresident, Val Based ENT &Cfo Jan 1, 2018
Calvin R Ford Individual Corporate DirectorBoard Member Jan 1, 2025
Gregory Pflum Individual Corporate DirectorBoard Member Sep 1, 2025
Henry Ford Allegiance Health Group Organization, Jackson, MI Corporation, Non-profit 5% Or Greater Direct Ownership Interest Apr 1, 2016 100%
Henry Ford Health Parent Organization, Detroit, MI Created for acquisition, Corporation, Non-profit 5% Or Greater Indirect Ownership Interest Oct 1, 2024 80%
Edward D Callaghan Individual Corporate DirectorBoard Member Sep 1, 2025
John F. Harris Individual Corporate DirectorBoard Member Jan 1, 2021
Ascension Health Organization, Saint Louis, MO Corporation, Non-profit 5% Or Greater Indirect Ownership Interest Oct 1, 2024 20%
Edgar Vann Individual Corporate DirectorBoard Member Jan 1, 2015
Lisa Fitzpatrick Individual Corporate DirectorBoard Member Sep 1, 2025
Joseph Richardson Individual Corporate DirectorBoard Member Jan 1, 2016
Gwendolyn M Mackenzie Individual Corporate DirectorBoard Member Sep 1, 2025
Jacalyn S. Goforth Individual Corporate DirectorBoard Member Jan 1, 2022
Eugene F Lovasco Individual Corporate DirectorBoard Member Oct 1, 2024

Owners & managing parties with NPI records 2

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 159

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 159

Practitioners & affiliated clinicians

Practitioners 3

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": "1159488000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1767744000000",
    "number": "1962594317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 N EAST AVE",
            "address_2": "7TH FL ONE JACKSON SQUARE",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "49201",
            "telephone_number": "517-788-4713",
            "fax_number": "517-841-7419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 N EAST AVE",
            "address_2": "7TH FL ONE JACKSON SQUARE",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "49201",
            "telephone_number": "517-788-4713",
            "fax_number": "517-841-7419"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "W.A. FOOTE MEMORIAL HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "W.A. FOOTE MEMORIAL HOSPITAL",
        "enumeration_date": "2006-09-29",
        "last_updated": "2026-01-07",
        "certification_date": "2026-01-07",
        "status": "A",
        "authorized_official_last_name": "DAMSCHRODER",
        "authorized_official_first_name": "ROBIN",
        "authorized_official_middle_name": "S.",
        "authorized_official_title_or_position": "EVP, CHIEF FIN & BUS DEV OFFICER",
        "authorized_official_telephone_number": "313-876-8452",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "273R00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Unit",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Henry Ford Allegiance Health",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Henry Ford Allegiance Health",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Henry Ford Health Jackson Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Jackson, MI

Sources for this page

Verify at the official NPI Registry.