HENRY FORD ALLEGIANCE HEALTH
NPI 1083971477
Internal Medicine in Jackson, MI
About Henry Ford Allegiance Health NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
HENRY FORD ALLEGIANCE HEALTH (NPI 1083971477) is a healthcare organization registered as an internal medicine in Jackson, Michigan and active in the NPI registry since April 2012. The organization holds a CLIA Waiver certificate valid through September 15, 2027 and lists Mark Smith, Svp, Cmo, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Names 1
Group Practice 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Henry Ford Allegiance Health is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Revalidation Due Date
Revalidation due by March 31, 2027
Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.
Clinicians Billing Medicare Through This Organization
225Medicare enrollment records show 225 clinicians reassign Medicare billing to Henry Ford Allegiance Health, which bills Medicare for the services they deliver. Of these, 27 practice at this address and 114 within 10 miles. Listed here are the 20 practicing nearest to this location.
Clinicians by Medicare Specialty 11
Nearest to this location (20)
See all 225Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
CLIA Laboratory Certificates CMS CLIA
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate of Waiver 23D0933589
Henry Ford Allegiance Surgery Center · Jackson, MIFrequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Wa Foote Memorial Hospital Inc.'s NPI number?
The NPI number for Wa Foote Memorial Hospital Inc. is 1083971477. It was assigned to this organization in the NPPES registry on April 23, 2012. The provider is doing business as Henry Ford Allegiance Health.
Where is Wa Foote Memorial Hospital Inc. located?
Wa Foote Memorial Hospital Inc. is located at 205 N East Ave, Jackson, MI 49201. The listed phone number is (517) 788-4800.
What is Wa Foote Memorial Hospital Inc.'s specialty?
The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.
Is Wa Foote Memorial Hospital Inc. enrolled in Medicare?
Yes. Wa Foote Memorial Hospital Inc. is registered in the Medicare PECOS enrollment system.
When is Wa Foote Memorial Hospital Inc.'s Medicare revalidation due?
According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (Michigan, Clinic/Group Practice) is due for revalidation by March 31, 2027. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.
How many clinicians bill Medicare through Wa Foote Memorial Hospital Inc.?
According to the CMS Revalidation Reassignment List (October 2026 release), 225 clinicians in 11 Medicare specialties reassign their Medicare billing to Wa Foote Memorial Hospital Inc.. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Nurse Practitioner (184), Cardiovascular Disease (Cardiology) (13) and Internal Medicine (6). Of these, 27 practice at this address and 114 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Wa Foote Memorial Hospital Inc. hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 23D0933589) is associated with this NPI, valid through September 15, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
What insurance does Wa Foote Memorial Hospital Inc. accept?
Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian and Blue Care Network of Michigan list Wa Foote Memorial Hospital Inc. as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Wa Foote Memorial Hospital Inc. was last updated on March 6, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Henry Ford Allegiance Health · NPI 1083971477
Internal Medicine organization in Jackson, Michigan. Organization record, active in the CMS NPPES registry since April 23, 2012.
## Identity
- **NPI:** 1083971477 (Entity type: Organization)
- **Enumerated:** April 23, 2012
- **Primary specialty:** Internal Medicine · taxonomy 207R00000X
- **Legal business name:** Wa Foote Memorial Hospital Inc.
- **Organization subpart:** Yes (part of Wa Foote Memorial Hospital Inc.)
- **Authorized official:** Mark Smith, SVP, CMO
## Practice location
- **Address:** 205 N EAST AVE, Jackson, MI 49201-1753
- **Phone:** (517) 788-4800
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Medicare revalidation due:** March 31, 2027 (Non-DME Part B, Michigan, Clinic/Group Practice) · CMS Revalidation Due Date List, October 2026 release
- **Clinicians billing through this organization:** 225 clinicians in 11 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Nurse Practitioner (184), Cardiovascular Disease (Cardiology) (13), Internal Medicine (6); 27 practice at this address and 114 within 10 miles; [full list](https://npiprofile.com/npi/1083971477/clinicians) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** March 6, 2024
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1083971477) · Data from the CMS NPPES public registry.