INDIANHEAD MEDICAL CENTER
NPI 1053859058
Clinic/Center - Primary Care in Siren, WI

Q: What is Indianhead Medical Center Shell Lake, Inc.'s specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Primary Care, with taxonomy code 261QP2300X.

Active since February 09, 2017CLIA 52D0397129 · Accreditation

7728 W MAIN ST, SIREN, WI 54872(715) 349-2910(715) 468-7303 Get Directions Write a Review

NPPES record last updated: March 9, 2020. Verified against the NPPES registry weekly; last sync: October 04, 2026.

Record update history: Mar 9, 2020, Aug 7, 2019, Feb 9, 2017 (3 updates tracked since 2017).

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About Indianhead Medical Center NPPES

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

INDIANHEAD MEDICAL CENTER (NPI 1053859058) is a healthcare organization registered as a primary care in Siren, Wisconsin and active in the NPI registry since February 2017. The organization holds an CLIA Accreditation certificate valid through January 2, 2027 and lists Shannon James Jack, Executive Vice President, as its authorized official.

NPPES Registry Identity

NPI1053859058

Entity TypeOrganization

Primary Taxonomy261QP2300X

Legal Business NameINDIANHEAD MEDICAL CENTER SHELL LAKE, INC.

Location Address7728 W MAIN STSiren, WI 54872-8041

Mailing AddressPo Box 300Shell Lake, WI 54871-0300 · (715) 468-7833 · Fax (715) 468-7303

Phone(715) 349-2910

Fax(715) 468-7303

Organization SubpartNo

Authorized OfficialShannon James JackExecutive Vice President · (715) 468-7833

Enumeration DateFebruary 9, 2017

Last NPPES UpdateMarch 9, 20203 updates tracked since enumeration

NPPES CertifiedMarch 9, 2020

✔ NPI 1053859058 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Primary CareAmbulatory Health Care Facilities

Taxonomy Code261QP2300X

7728 W MAIN ST, Siren, WI 54872

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Other Names 1

Doing Business AsIndianhead Medical Center

Other Identifiers 1

Medicaid11020710WI

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include HealthPartners.Insurance ›

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 Accreditation 52D0397129

Indianhead Medical Center Inc · Shell Lake, WI

Active · expires Jan 2, 2027

CLIA Number52D0397129

Laboratory TypeHospital

Certificate Effective DateJanuary 3, 2025

Certificate Expiration DateJanuary 2, 2027

Laboratory DirectorDr. Greg C. Heiler

Laboratory Phone(715) 468-7833

Laboratory LocationIndianhead Medical Center Inc113 Fourth Ave PO Box 300, Shell Lake, WI 54871

CLIA data matches this NPI record on: Name Phone

This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

INDIANHEAD MEDICAL CENTER SHELL LAKE, INC.

Clinic/Center (Rural Health)

7728 W MAIN ST
SIREN, WI 54872

Burnett County (153) 492-9107

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 Indianhead Medical Center Shell Lake, Inc.'s NPI number?

The NPI number for Indianhead Medical Center Shell Lake, Inc. is 1053859058. It was assigned to this organization in the NPPES registry on February 9, 2017. The provider is doing business as Indianhead Medical Center.

Where is Indianhead Medical Center Shell Lake, Inc. located?

Indianhead Medical Center Shell Lake, Inc. is located at 7728 W Main St, Siren, WI 54872. The listed phone number is (715) 349-2910.

What is Indianhead Medical Center Shell Lake, Inc.'s specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Primary Care, with taxonomy code 261QP2300X.

Does Indianhead Medical Center Shell Lake, Inc. hold a CLIA laboratory certificate?

Yes. A Certificate of Accreditation (number 52D0397129) is associated with this NPI, valid through January 2, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Indianhead Medical Center Shell Lake, Inc. accept?

Health plans from HealthPartners list Indianhead Medical Center Shell Lake, 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 Indianhead Medical Center Shell Lake, Inc. was last updated on March 9, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.