HENRY FORD ALLEGIANCE HEALTH
NPI 1265487722
Emergency Medicine in Jackson, MI
NPI Status: Active since May 23, 2006
- Organization
- Emergency Medicine
- Accepts Insurance
- CLIA Number: 23D0378403
- CLIA Cert. Type: Hospital
- CLIA Exp. Date: 02-27-2027
About HENRY FORD ALLEGIANCE HEALTH
This page provides the complete NPI Profile along with additional information for Henry Ford Allegiance Health, a provider established in Jackson, Michigan operating as a Emergency Medicine. The healthcare provider is registered in the NPI registry with number 1265487722 assigned on May 2006. The practitioner's primary taxonomy code is 207P00000X. The provider is registered as an organization and their NPI record was last updated 9 years ago. Henry Ford Allegiance Health operates as a multi-specialty business group with one or more individual providers who practice different areas of specialization. The provider's is doing business as Henry Ford Allegiance Health. The authorized official of this NPI record is Jeanne' Wickens Cfo (Senior Vice President Of Finance)
- NPI
- 1265487722
- Provider Legal Name
- WA FOOTE MEMORIAL HOSPITAL, INC
- Other Organization Name
- HENRY FORD ALLEGIANCE HEALTH
- Other Name Type
- Doing Business As (3)
- Entity Type
- Organization
- Location Address
- 205 N EAST AVE JACKSON, MI 49201
- Location Phone
- (517) 788-4800
- Mailing Address
- DEPARTMENT 272801 PO BOX 67000 DETROIT, MI 48267
- Mailing Phone
- (517) 841-7482
- Mailing Fax
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- Yes
- Enumeration Date
- 05-23-2006
- Last Update Date
- 04-01-2016
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Emergency Medicine
- Taxonomy Code
- 207P00000X
- Type
- Allopathic & Osteopathic Physicians
- License State
- MI
- Taxonomy Description
- An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 363A00000X | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | (MI) |
Group Taxonomy 193200000X MULTI-SPECIALTY GROUP
This provider is a business group of one or more individual practitioners, who practice with different areas of specialization.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Clear Silver - HMO
- Elite Bronze - HMO
- Elite Bronze + Vision + Adult Dental - HMO
- Elite Gold - HMO
- Elite Gold + Vision + Adult Dental - HMO
- Everyday Bronze - HMO
- Everyday Bronze + Vision + Adult Dental - HMO
- Everyday Gold - HMO
- Everyday Gold + Vision + Adult Dental - HMO
- Focused Silver - HMO
- Choice Bronze HSA - HMO
- Choice Bronze HSA + Vision + Adult Dental - HMO
- Clear Gold - HMO
- Clear Gold + Vision + Adult Dental - HMO
- Clear Silver - HMO
- Complete Gold - HMO
- Complete Gold + Vision + Adult Dental - HMO
- Complete Silver - HMO
- Complete Silver + Vision + Adult Dental - HMO
- Elite Gold - HMO
- MyPriority Balanced Silver - HMO
- MyPriority Premier Silver - HMO
- MyPriority Standard Bronze - HMO
- MyPriority Standard Bronze - Travel - HMO
- MyPriority Standard Gold - HMO
- MyPriority Standard Silver - HMO
- MyPriority Standard Silver - Travel - HMO
- MyPriority Value Bronze - HMO
- MyPriority Value Bronze HSA - HMO
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 700C810330 | OTHER (01) | MI | BCBSM DOCTORS |
| 0M88560 | MEDICARE PIN (08) | MI | |
| CC5829 | OTHER (01) | MI | RR MEDICARE |
| 0N79450 | MEDICARE PIN (08) | MI |
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 23D0378403
- Facility Type
- Hospital
- Certificate Effective Date
- February 28, 2025
- Certificate Expiration Date
- February 27, 2027
- Laboratory Director
- NEIL C. CALIMAN
- Certificate Type
- Certificate of Accreditation
- Certificate Type Description
- This is a CLIA certificate is issued to Henry Ford Allegiance Health on the basis of the laboratory's accreditation by an accreditation organization approved by CMS. This type of certificate is issued to a laboratories tha perform nonwaived (moderate and/or high complexity) testing.
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 2 | 6 | 5 | 4 | 8 | 7 | 7 | 2 | 2 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 2 | 12 | 5 | 8 | 8 | 14 | 7 | 4 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 2 + 1 + 2 + 5 + 8 + 8 + 1 + 4 + 7 + 4 + 24 = 68 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 70 - 68 = 2 | 2 | ||||||||
The NPI number 1265487722 is valid because the calculated check digit 2 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 20 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1134121684 | DEEPA S MACHA MD Individual | Emergency Medicine | 205 N EAST AVE JACKSON, MI 49201 (517) 788-4996 |
| 1336116664 | WALTER A. WITHERSPOON CRNA Individual | Nurse Anesthetist, Certified Registered | 205 N EAST AVE JACKSON, MI 49201 (517) 788-4800 |
| 1699732677 | JOHN STEVEN MOGERMAN MD Individual | Psychiatry & Neurology (Psychiatry) | 205 N EAST AVE JACKSON, MI 49201 (517) 788-4730 |
| 1548226624 | DAVID ERIK REMMLER MD Individual | Emergency Medicine | 205 N EAST AVE JACKSON, MI 49201 (517) 788-4996 |
| 1053377044 | JAMES BROWN CHAUNCEY III MD Individual | Internal Medicine (Pulmonary Disease) | 205 N EAST AVE JACKSON, MI 49201 (517) 788-4800 |
| 1962468090 | TERRANCE WAYNE MACGREGOR MD Individual | Emergency Medicine | 205 N EAST AVE JACKSON, MI 49201 (517) 788-4996 |
| 1285690230 | DAVID FARHAT MD Individual | Emergency Medicine | 205 N EAST AVE JACKSON, MI 49201 (517) 788-4996 |
| 1619933660 | GREGORY WILLIAM BAUMANN MD Individual | Emergency Medicine | 205 N EAST AVE JACKSON, MI 49201 (517) 788-4996 |
| 1720044738 | RAVI SINGH KIRBAT MD Individual | Psychiatry & Neurology (Psychiatry) | 205 N EAST AVE JACKSON, MI 49201 (517) 788-4730 |
| 1437116001 | RICHARD J ENTER PHD Individual | Psychologist | 205 N EAST AVE JACKSON, MI 49201 (517) 788-4730 |
| 1437116118 | SAMY YOUSEF WASSEF MD Individual | Psychiatry & Neurology (Psychiatry) | 205 N EAST AVE JACKSON, MI 49201 (517) 788-4730 |
| 1306803085 | LEE ANNE GREEN SNYDER PHD Individual | Psychologist | 205 N EAST AVE JACKSON, MI 49201 (517) 788-4730 |
| 1528025905 | GEOFFERY LYLE STEVENS CSW Individual | Social Worker | 205 N EAST AVE JACKSON, MI 49201 (517) 788-4730 |
| 1801854344 | JOSE TAD-Y EDURESE MD Individual | Internal Medicine | 205 N EAST AVE JACKSON, MI 49201 (517) 788-4800 |
| 1437117991 | KRISTIN ANN DRAFFEN CSW Individual | Social Worker | 205 N EAST AVE JACKSON, MI 49201 (517) 789-5971 |
| 1841258308 | NADINE LYN ZINN NP Individual | Nurse Practitioner | 205 N EAST AVE JACKSON, MI 49201 (517) 788-4786 |
| 1881642320 | DAVID R WALKER PA Individual | Physician Assistant | 205 N EAST AVE JACKSON, MI 49201 (517) 788-4996 |
| 1255380796 | KENNETH MICHAEL GORNEY MSW Individual | Physician Assistant | 205 N EAST AVE JACKSON, MI 49201 (517) 789-5971 |
| 1881644300 | LONNA KAY OTIS-PEPPER NP Individual | Nurse Practitioner | 205 N EAST AVE JACKSON, MI 49201 (517) 788-4958 |
| 1295786630 | HOLLY JO PAUL NP Individual | Nurse Practitioner | 205 N EAST AVE JACKSON, MI 49201 (517) 788-4996 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1265487722, enumerated in the NPI registry as an "organization" on May 23, 2006
The provider is located at 205 N East Ave Jackson, Mi 49201 and the phone number is (517) 788-4800
This medical organization specializes in Emergency Medicine with taxonomy code 207P00000X
The provider might be accepting Accepts: Ambetter from Meridian, Ambetter Health, Priority. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
The provider's CLIA number is 23D0378403 for a "hospital" facility with a CLIA Certificate of Accreditation. This is a CLIA certificate is issued on the basis of the laboratory's accreditation by an accreditation organization approved by CMS. This type of certificate is issued to a laboratories tha perform nonwaived (moderate and/or high complexity) testing..
This NPI record was last updated on May 23, 2006. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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