HENRY FORD ALLEGIANCE HEALTH
NPI 1124052279
Nurse Practitioner 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 1124052279) is a healthcare organization registered as a nurse practitioner in Jackson, Michigan and active in the NPI registry since July 2006. The organization lists Mark Smith, Svp, Cmo, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 3
Other Names 1
Other Identifiers 2
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, 28 practice at this address and 115 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.
Frequently 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 1124052279. It was assigned to this organization in the NPPES registry on July 11, 2006. 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 Nurse Practitioner with taxonomy code 363L00000X.
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, 28 practice at this address and 115 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 1124052279
Nurse Practitioner organization in Jackson, Michigan. Organization record, active in the CMS NPPES registry since July 11, 2006.
## Identity
- **NPI:** 1124052279 (Entity type: Organization)
- **Enumerated:** July 11, 2006
- **Primary specialty:** Nurse Practitioner · taxonomy 363L00000X
- **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); 28 practice at this address and 115 within 10 miles; [full list](https://npiprofile.com/npi/1124052279/clinicians) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** March 6, 2024
- **Other identifiers:** Other CC5829 (MI); Other 500C810310 (MI)
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Source: [NPI Profile](https://npiprofile.com/npi/1124052279) · Data from the CMS NPPES public registry.