| Henry Ford Allegiance Health | |
|
205 N East Ave Jackson MI 49201-1753 | |
| (517) 788-4800 | |
| Not Available |
| Full Name | Henry Ford Allegiance Health |
|---|---|
| Speciality | Internal Medicine |
| Location | 205 N East Ave, Jackson, Michigan |
| Authorized Official Name and Position | Mark Smith (SVP. CMO) |
| Authorized Official Contact | 5172056407 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Henry Ford Allegiance Health Po Box 67000 Department 272801 Detroit MI 48267-2728 Ph: (517) 841-7482 | Henry Ford Allegiance Health 205 N East Ave Jackson MI 49201-1753 Ph: (517) 788-4800 |
| NPI Number | 1831123728 |
|---|---|
| Provider Enumeration Date | 07/10/2006 |
| Last Update Date | 03/06/2024 |
| Medicare PECOS PAC ID | 0244136067 |
|---|---|
| Medicare Enrollment ID | O20031212000875 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831123728 | NPI | - | NPPES |
| CC5829 | Other | MI | RR MEDICARE |
| 700C860070 | Other | MI | BCBSM/MD/DO |
| Provider Name | Arvind Shanka Prabhu |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1952378432 PECOS PAC ID: 4789578329 Enrollment ID: I20040212000775 |
| Provider Name | Robert D Albertson |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1487610481 PECOS PAC ID: 8224926795 Enrollment ID: I20040306000189 |
| Provider Name | Gregg A Patten |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1699720771 PECOS PAC ID: 6204724776 Enrollment ID: I20040306000202 |
| Provider Name | James Chauncey |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1053377044 PECOS PAC ID: 3870481880 Enrollment ID: I20040310000086 |
| Provider Name | Matthew G Moore |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1437105640 PECOS PAC ID: 1355233545 Enrollment ID: I20040324001700 |
| Provider Name | Haresh Jani |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1760486583 PECOS PAC ID: 2668469651 Enrollment ID: I20040430000089 |
| Provider Name | William B Bivens |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1114029071 PECOS PAC ID: 4981675816 Enrollment ID: I20040804000738 |
| Provider Name | Bruce S Barbour |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1386602761 PECOS PAC ID: 3274512728 Enrollment ID: I20050526000178 |
| Provider Name | Thomas K Song |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1427073428 PECOS PAC ID: 7911941497 Enrollment ID: I20050615000571 |
| Provider Name | Kimberly Dawn Aiken |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1154387116 PECOS PAC ID: 0244275550 Enrollment ID: I20050627000607 |
| Provider Name | Vlad Motoc |
|---|---|
| Provider Type | Practitioner - Geriatric Medicine |
| Provider Identifiers | NPI Number: 1164462693 PECOS PAC ID: 5496715690 Enrollment ID: I20060106000375 |
| Provider Name | Sanjeev Aggarwal |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1669480273 PECOS PAC ID: 6103866371 Enrollment ID: I20061023000477 |
| Provider Name | Hasan M Qutob |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1285793521 PECOS PAC ID: 7012917487 Enrollment ID: I20070109000137 |
| Provider Name | Shivakumar Reddy Deva |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1750427159 PECOS PAC ID: 1658474879 Enrollment ID: I20070308000409 |
| Provider Name | Yasser Moussa Aleech |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1871698639 PECOS PAC ID: 2860396322 Enrollment ID: I20070906000068 |
| Provider Name | Heather L Simpkins |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1194916601 PECOS PAC ID: 1456445329 Enrollment ID: I20070922000138 |
| Provider Name | Gregory L Goyert |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1083663983 PECOS PAC ID: 7618057043 Enrollment ID: I20080110000247 |
| Provider Name | Bradley Judge |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1093774291 PECOS PAC ID: 7416023841 Enrollment ID: I20080908000499 |
| Provider Name | Khurshaid Alam |
|---|---|
| Provider Type | Practitioner - Interventional Radiology |
| Provider Identifiers | NPI Number: 1588871826 PECOS PAC ID: 0345398277 Enrollment ID: I20090504000443 |
| Provider Name | Lynn C Vanwagnen |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1609833359 PECOS PAC ID: 0244136075 Enrollment ID: I20091013000163 |
| Provider Name | Tanya R Wynn |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1356574909 PECOS PAC ID: 4486792132 Enrollment ID: I20091117000521 |
| Provider Name | Milan V Pantelic |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1013085752 PECOS PAC ID: 2264562008 Enrollment ID: I20100604000930 |
| Provider Name | James Bennett Baker |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1790791952 PECOS PAC ID: 4587796214 Enrollment ID: I20100715000953 |
| Provider Name | David Lee Halsey |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1457319832 PECOS PAC ID: 4486550217 Enrollment ID: I20100728000748 |
| Provider Name | Jashu R Patel |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1366408692 PECOS PAC ID: 3274502273 Enrollment ID: I20100813001058 |
| Provider Name | Imdad H Butt |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1548210487 PECOS PAC ID: 1557555810 Enrollment ID: I20101101000042 |
| Provider Name | Jeffrey Douglas Nadig |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1396863155 PECOS PAC ID: 4688869878 Enrollment ID: I20101112001227 |
| Provider Name | Kimberly K Monroe |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1124012984 PECOS PAC ID: 3678762291 Enrollment ID: I20110113000565 |
| Provider Name | Anish Wadhwa |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1235348400 PECOS PAC ID: 2062569155 Enrollment ID: I20110502000259 |
| Provider Name | Rami A Alzebdeh |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1497954598 PECOS PAC ID: 2668650979 Enrollment ID: I20110708000341 |
| Provider Name | Ronald A Nichols |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1245532134 PECOS PAC ID: 0648430124 Enrollment ID: I20120320000664 |
| Provider Name | Namrata Vashishta |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1366691719 PECOS PAC ID: 3072742600 Enrollment ID: I20140131000634 |
| Provider Name | Sun Kwon Kim |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1023386877 PECOS PAC ID: 0749404069 Enrollment ID: I20140606000747 |
| Provider Name | Sireen Thegalapalle Reddy |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1518123298 PECOS PAC ID: 7416144266 Enrollment ID: I20141114000367 |
| Provider Name | Thomas W Keimig |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1689800047 PECOS PAC ID: 6901038967 Enrollment ID: I20150827003162 |
| Provider Name | Candice K Gates |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1205191202 PECOS PAC ID: 7416242003 Enrollment ID: I20160822001246 |
| Provider Name | Nicholas R Reeser |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1841599362 PECOS PAC ID: 7113159070 Enrollment ID: I20161026002802 |
| Provider Name | Justin T Conley |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1033135298 PECOS PAC ID: 9931103330 Enrollment ID: I20161028001702 |
| Provider Name | Kevin Walker |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1265846158 PECOS PAC ID: 8921314311 Enrollment ID: I20161110002048 |
| Provider Name | Majid Shaman |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1689814501 PECOS PAC ID: 1658423223 Enrollment ID: I20170615000524 |
| Provider Name | Irina Dimitrova |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1003847237 PECOS PAC ID: 8527082999 Enrollment ID: I20180907002626 |
| Provider Name | Raminder Kaur Khangura |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1184967085 PECOS PAC ID: 4284907908 Enrollment ID: I20200428000920 |
| Provider Name | D'angela Sherise Pitts |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1689019507 PECOS PAC ID: 0345539573 Enrollment ID: I20200506002381 |
| Provider Name | Firas Shalabi |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1841851730 PECOS PAC ID: 3274860663 Enrollment ID: I20230511002232 |
| Provider Name | Ola Hadaya |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1861981664 PECOS PAC ID: 3971926924 Enrollment ID: I20230714001206 |
| Provider Name | Leah Hong |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1174985154 PECOS PAC ID: 2961795174 Enrollment ID: I20230719003813 |
| Provider Name | Haleema Saeed |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1477947810 PECOS PAC ID: 8224482708 Enrollment ID: I20231003000320 |
Diagnostic Ultrasound Clinic Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2575 Spring Arbor Rd, Suite 200, Jackson, MI 49203 Phone: 517-784-0020 Fax: 517-787-8329 | |
Aaron Van Wagnen Md Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1310 Greenwood Ave, Jackson, MI 49203 Phone: 517-787-1990 Fax: 517-787-9183 | |
Jackson Family Medical Pllc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 724 W Franklin St, Jackson, MI 49201 Phone: 517-784-3100 Fax: 517-784-3200 | |
Lorna G. Pinson, Md Pllc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 744 W Michigan Ave, Suite 101, Jackson, MI 49201 Phone: 517-782-2540 Fax: 517-782-1560 | |
Mid-michigan Health Centers Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 214 N West Ave, Jackson, MI 49201 Phone: 517-784-9189 Fax: 517-784-9657 | |
Henry Ford Allegiance Health Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 205 N East Ave, Jackson, MI 49201 Phone: 517-788-4800 | |
Center For Family Health At Lifeways Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1200 N West Ave, Jackson, MI 49202 Phone: 517-748-5500 Fax: 517-780-9286 |