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Organization Active NPI

Henry Ford Wyandotte Hospital

  • Rehabilitation Hospital
  • Wyandotte, MI
National Provider Identifier
1982853560
Registry record updated Mar 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation HospitalTaxonomy code 283X00000X
License
820230 Issued in MI
Legal business name
HENRY FORD WYANDOTTE HOSPITAL
Practice address
2333 Biddle Ave
Wyandotte, MI 48192-4668
Phone
(734) 246-6000
Fax
(734) 246-6986
NPI assigned
Sep 18, 2008
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Robin S. Damschroder
Title
Evp, Fin and Bus Dev Officer
Phone
(313) 876-8452

Owners & managing parties with NPI records 2

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

Other NPIs with the same Medicare PAC ID 8

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

Member of 1

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

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

Facilities with the same owner 159

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

View all 159

Practitioners 195

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 195

Affiliated clinicians 18

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 18

Care Compare: Inpatient rehabilitation facility

Medicare Care Compare
Listed as
Henry Ford Wyandotte HospitalCCN 23T146
Ownership
Non-profit
Certified
Oct 1, 1983

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071210000517 MI Part a Provider - Hospital 2264334499 Practice locations: Wyandotte, MI

Hospital certification: CCN 23T146

Medicare enrollment files
Legal name
HENRY FORD WYANDOTTE HOSPITAL
Doing business as
HENRY FORD WYANDOTTE HOSPITAL
Organization structure
CorporationNon-profit
Enrollment address
2333 Biddle Ave
Wyandotte, MI 48192-4668
Hospital Rehabilitation Unit
Hospital subgroups
Rehabilitation unit

All disclosed owners & managing parties 31

Medicare enrollment files

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 Director Jan 1, 2022
Henry Ford Health System Organization, Troy, MI Corporation, Non-profit, Chain home office, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Dec 18, 1987 100%
Charles McClure Individual Corporate Director Jul 25, 2014
Robert R Lubera Individual Corporate DirectorBoard Member Sep 1, 2025
Frederiek Toney Individual Corporate Director Jan 1, 2021
Barry G. Porter Individual Corporate Director Jan 1, 2020
Steven Brian Bender Individual Corporate OfficerSecretary Oct 21, 2024
Gerardo Norcia Individual Corporate Director Dec 1, 2023
Robert Riney Individual Corporate Director Jul 1, 2022
Michael Rafferty Individual Corporate Director Jan 1, 2020
Jeffrey Fall Individual Corporate DirectorBoard Member Sep 1, 2025
Farzan Siddiqui Individual Corporate Director Jan 1, 2024
Marjorie Staten Individual Corporate Officer Jan 1, 2019
Rhonda M Medows Individual Corporate DirectorBoard Member Sep 1, 2025
David Breen Individual Corporate Director 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 Director Oct 1, 2024
Robin S. Damschroder Individual Corporate Officer Jan 1, 2018
Calvin R Ford Individual Corporate DirectorBoard Member Jan 1, 2025
Gregory Pflum Individual Corporate DirectorBoard Member Sep 1, 2025
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 Director 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 Director Jan 1, 2015
Lisa Fitzpatrick Individual Corporate DirectorBoard Member Sep 1, 2025
Joseph Richardson Individual Corporate Director Jan 1, 2016
Gwendolyn M Mackenzie Individual Corporate DirectorBoard Member Sep 1, 2025
Jacalyn S. Goforth Individual Corporate Director Jan 1, 2022
Eugene F Lovasco Individual Corporate Director Oct 1, 2024

National Provider Directory

National Provider Directory
Tax ID family
Henry Ford Wyandotte21 organizations share this tax ID, including this one

Other organizations with this tax ID 20

Organizations that report the same tax identification number in the National Provider Directory.

View all 20

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Hospital 283X00000X 820230 MI Primary

Addresses

NPPES NPI Registry

Primary practice location

2333 Biddle Ave
Wyandotte, MI 48192-4668

Mailing address

2333 Biddle Ave
Wyandotte, MI 48192-4668
Phone (734) 246-6000

Other identifiers 3

NPPES NPI Registry
IdentifierTypeStateIssuer
301892495MedicaidMI
00285OtherMIBCN
00285OtherMIBLUE CROSS

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Mar 6, 2024.

{
    "created_epoch": "1221696000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709683200000",
    "number": "1982853560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2333 BIDDLE AVE",
            "city": "WYANDOTTE",
            "state": "MI",
            "postal_code": "481924668",
            "telephone_number": "734-246-6000",
            "fax_number": "734-246-6986"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2333 BIDDLE AVE",
            "city": "WYANDOTTE",
            "state": "MI",
            "postal_code": "481924668",
            "telephone_number": "734-246-6000",
            "fax_number": "734-246-6986"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HENRY FORD WYANDOTTE HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-18",
        "last_updated": "2024-03-06",
        "certification_date": "2024-03-06",
        "status": "A",
        "authorized_official_last_name": "DAMSCHRODER",
        "authorized_official_first_name": "ROBIN",
        "authorized_official_middle_name": "S.",
        "authorized_official_title_or_position": "EVP, FIN AND BUS DEV OFFICER",
        "authorized_official_telephone_number": "313-876-8452"
    },
    "taxonomies": [
        {
            "code": "283X00000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Hospital",
            "state": "MI",
            "license": "820230",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "301892495",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCN",
            "identifier": "00285",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "00285",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wyandotte, MI

Sources for this page

Verify at the official NPI Registry.