HENRY FORD ALLEGIANCE HEALTH
NPI 1366988347
Nurse Practitioner in Jackson, MI

Active since January 13, 2017
205 N. EAST AVE, JACKSON, MI 49201(517) 205-7843 Get Directions Write a Review

NPPES record last updated: July 29, 2024. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Jul 29, 2024, Mar 6, 2024, Jul 21, 2022 and 4 more (7 updates tracked since 2017).

About Henry Ford Allegiance Health NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

HENRY FORD ALLEGIANCE HEALTH (NPI 1366988347) is a healthcare organization registered as a nurse practitioner in Jackson, Michigan and active in the NPI registry since January 2017. The organization lists Mark Smith, Svp, Cmo, Ceo, as its authorized official.

NPPES Registry Identity

NPI1366988347
Entity TypeOrganization
Primary Taxonomy363L00000X
Legal Business NameW.A. FOOTE MEMORIAL HOSPITAL, INC
Location Address205 N. EAST AVEJackson, MI 49201
Mailing AddressPo Box 67000, Department 272801Detroit, MI 48267-2728 · (517) 205-7843 · Fax (517) 841-7419
Organization SubpartYesParent: Allegiance Health Services
Authorized OfficialMark SmithSvp, Cmo, Ceo · (517) 205-6407
Enumeration DateJanuary 13, 2017
Last NPPES UpdateJuly 29, 20247 updates tracked since enumeration
NPPES CertifiedJuly 29, 2024
✔ NPI 1366988347 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 9

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363L00000X
License✔ Licensed in MI · 1060000044
Definition
(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.
Also ListedNurse Practitioner · Acute CareTaxonomy 363LA2100X
Also ListedNurse Practitioner · Adult HealthTaxonomy 363LA2200X
Also ListedNurse Practitioner · FamilyTaxonomy 363LF0000X
Also ListedNurse Practitioner · GerontologyTaxonomy 363LG0600X
Also ListedNurse Practitioner · PediatricsTaxonomy 363LP0200X
Also ListedNurse Practitioner · Women's HealthTaxonomy 363LW0102X
Also ListedAdvanced Practice MidwifeTaxonomy 367A00000X
205 N. EAST AVE, Jackson, MI 49201

Other Names 1

Doing Business AsHenry Ford Allegiance Health

Other Identifiers 1

Medicaid1629000708MI

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

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.

StateEnrollment IDDue date
StateMichiganEnrollment IDO20040612000395Non-DME Part B · Clinic/Group PracticeDue dateMarch 31, 2027
Source: CMS Revalidation Due Date List, October 2026 release.

Clinicians Billing Medicare Through This Organization

225

Medicare 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

Nurse Practitioner184
Cardiovascular Disease (Cardiology)13
Internal Medicine6
Interventional Cardiology6
Certified Nurse Midwife (CNM)4
Pulmonary Disease4
Cardiac Electrophysiology2
Pediatric Medicine2
3 other specialties4

Nearest to this location (20)

See all 225
Nurse Practitioner
NPI 1578124632
205 N EAST AVE
Jackson, MI 49201
(517) 205-4800
✔ PECOS✔ Accepts MedicareSame address
Nurse Practitioner
NPI 1396023719
205 N EAST AVE
Jackson, MI 49201
(517) 205-3076
✔ PECOSSame address
Certified Nurse Midwife (CNM)
NPI 1811626765
205 N EAST AVE
Jackson, MI 49201
(517) 205-4800
✔ PECOS✔ Accepts MedicareSame address
Nurse Practitioner
NPI 1952918849
205 N EAST AVE
Jackson, MI 49201
(517) 250-4800
✔ PECOS✔ Accepts MedicareSame address
Nurse Practitioner
NPI 1437867793
205 N EAST AVE
Jackson, MI 49201
(517) 205-3076
✔ PECOS✔ Accepts MedicareSame address
Nurse Practitioner
NPI 1366060949
205 N EAST AVE
Jackson, MI 49201
(517) 788-4786
✔ PECOSSame address
Nurse Practitioner
NPI 1417542200
205 N EAST AVE
Jackson, MI 49201
(517) 205-4800
✔ PECOSSame address
Nurse Practitioner
NPI 1053103663
205 N EAST AVE
Jackson, MI 49201
(517) 205-4800
✔ PECOS✔ Accepts MedicareSame address
Nurse Practitioner
NPI 1083443105
205 N EAST AVE
Jackson, MI 49201
(517) 205-4800
✔ PECOS✔ Accepts MedicareSame address
Certified Nurse Midwife (CNM)
NPI 1467258913
205 N EAST AVE
Jackson, MI 49201
(517) 205-7836
✔ PECOS✔ Accepts MedicareSame address
Nurse Practitioner
NPI 1790185189
205 N EAST AVE
Jackson, MI 49201
(517) 788-4730
✔ PECOS✔ Accepts MedicareSame address
Nurse Practitioner
NPI 1003066218
205 N EAST AVE
Jackson, MI 49201
(517) 205-4800
✔ PECOS✔ Accepts MedicareSame address
Nurse Practitioner
NPI 1972551414
205 N EAST AVE
Jackson, MI 49201
(517) 788-4996
✔ PECOS✔ Accepts MedicareSame address
Nurse Practitioner
NPI 1356093553
205 N EAST AVE
Jackson, MI 49201
(517) 205-7836
✔ PECOS✔ Accepts MedicareSame address
Nurse Practitioner
NPI 1962170407
214 N WEST AVE
Jackson, MI 49201
(517) 784-9189
✔ PECOS✔ Accepts MedicareSame address
Nurse Practitioner
NPI 1104593318
205 N EAST AVE
Jackson, MI 49201
(517) 205-4800
✔ PECOS✔ Accepts MedicareSame address
Nurse Practitioner
NPI 1881644300
205 N EAST AVE
Jackson, MI 49201
(517) 788-4958
✔ PECOS✔ Accepts MedicareSame address
Nurse Practitioner
NPI 1295786630
205 N EAST AVE
Jackson, MI 49201
(517) 788-4996
✔ PECOS✔ Accepts MedicareSame address
Nurse Practitioner
NPI 1952162836
205 N EAST AVE
Jackson, MI 49201
(517) 205-4800
✔ PECOS✔ Accepts MedicareSame address
Nurse Practitioner
NPI 1750049078
205 N EAST AVE
Jackson, MI 49201
(517) 205-7917
✔ PECOS✔ Accepts MedicareSame address
See all 225 clinicians

Source: 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 W.A. Foote Memorial Hospital, Inc's NPI number?

The NPI number for W.A. Foote Memorial Hospital, Inc is 1366988347. It was assigned to this organization in the NPPES registry on January 13, 2017. The provider is doing business as Henry Ford Allegiance Health.

Where is W.A. Foote Memorial Hospital, Inc located?

W.A. Foote Memorial Hospital, Inc is located at 205 N. East Ave, Jackson, MI 49201. The listed phone number is (517) 205-7843.

What is W.A. Foote Memorial Hospital, Inc's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Is W.A. Foote Memorial Hospital, Inc enrolled in Medicare?

Yes. W.A. Foote Memorial Hospital, Inc is registered in the Medicare PECOS enrollment system.

When is W.A. 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 W.A. 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 W.A. 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 W.A. Foote Memorial Hospital, Inc accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, Blue Care Network of Michigan and Blue Cross Blue Shield of Michigan Mutual Insurance Company list W.A. 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 W.A. Foote Memorial Hospital, Inc was last updated on July 29, 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.