INDIANHEAD MEDICAL CENTER SHELL LAKE, INC
NPI 1568438125
General Acute Care Hospital - Critical Access in Shell Lake, WI
About Indianhead Medical Center Shell Lake, Inc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
INDIANHEAD MEDICAL CENTER SHELL LAKE, INC (NPI 1568438125) is a healthcare organization registered as a critical access in Shell Lake, Wisconsin and active in the NPI registry since February 2006. The organization lists Shannon J Jack, Executive Vice President, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Indianhead Medical Center Shell Lake, Inc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
2Medicare enrollment records show 2 clinicians reassign Medicare billing to Indianhead Medical Center Shell Lake, Inc, which bills Medicare for the services they deliver. Of these, 2 practice at this address. They are listed nearest first.
Clinicians, nearest first (2)
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 Indianhead Medical Center Shell Lake, Inc's NPI number?
The NPI number for Indianhead Medical Center Shell Lake, Inc is 1568438125. It was assigned to this organization in the NPPES registry on February 24, 2006.
Where is Indianhead Medical Center Shell Lake, Inc located?
Indianhead Medical Center Shell Lake, Inc is located at 113 4th Avenue, Shell Lake, WI 54871. The listed phone number is (715) 468-7833.
What is Indianhead Medical Center Shell Lake, Inc's specialty?
The primary specialty registered for this NPI is General Acute Care Hospital, specializing in Critical Access, with taxonomy code 282NC0060X.
Is Indianhead Medical Center Shell Lake, Inc enrolled in Medicare?
Yes. Indianhead Medical Center Shell Lake, Inc is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Indianhead Medical Center Shell Lake, Inc?
According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians reassign their Medicare billing to Indianhead Medical Center Shell Lake, Inc, in Nurse Practitioner and Pediatric Medicine. 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. Of these, 2 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
What insurance does Indianhead Medical Center Shell Lake, Inc accept?
Health plans from Anthem Blue Cross and Blue Shield and Security Health Plan 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.
# Indianhead Medical Center Shell Lake, Inc · NPI 1568438125
Critical Access organization in Shell Lake, Wisconsin. Organization record, active in the CMS NPPES registry since February 24, 2006.
## Identity
- **NPI:** 1568438125 (Entity type: Organization)
- **Enumerated:** February 24, 2006
- **Primary specialty:** General Acute Care Hospital - Critical Access · taxonomy 282NC0060X
- **Organization subpart:** No
- **Authorized official:** Shannon Jack, EXECUTIVE VICE PRESIDENT
## Practice location
- **Address:** 113 4TH AVENUE, Shell Lake, WI 54871
- **Phone:** (715) 468-7833
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 2 clinicians in 2 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Nurse Practitioner (1), Pediatric Medicine (1); 2 practice at this address · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** March 9, 2020
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Source: [NPI Profile](https://npiprofile.com/npi/1568438125) · Data from the CMS NPPES public registry.