Indianhead Medical Center Shell Lake, Inc.
NPI 1053859058 · Primary Care Clinic/Center · Siren, WI
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Indianhead Medical Center Shell Lake, Inc. is a Primary Care Clinic/Center organization in Siren, WI (NPI 1053859058).
Provider details
- NPI number
- 1053859058
- Entity type
- Organization
- Primary specialty
- Primary Care Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Shannon Jack, Executive Vice President(715) 468-7833
Specialties & taxonomies
Ambulatory Health Care Facilities
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
9 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Other names (DBA / former)
- Doing business as
- Indianhead Medical Center
- Doing business as
- Indianhead Medical Center
Registry dates
- Enumerated
- 2017-02-09
- Last updated
- 2020-03-09
- Certified
- 2020-03-09
Frequently asked questions
- What is Indianhead Medical Center Shell Lake, Inc.'s NPI number?
- Indianhead Medical Center Shell Lake, Inc.'s National Provider Identifier (NPI) is 1053859058, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Indianhead Medical Center Shell Lake, Inc.?
- Indianhead Medical Center Shell Lake, Inc. is classified in the NPPES registry as Primary Care Clinic/Center (Ambulatory Health Care Facilities).
- Where is Indianhead Medical Center Shell Lake, Inc. located?
- Indianhead Medical Center Shell Lake, Inc.'s practice location on file with NPPES is 7728 W Main St, Siren, WI 54872-8041.
- What is Indianhead Medical Center Shell Lake, Inc.'s phone number?
- The practice phone number listed in the NPPES registry for Indianhead Medical Center Shell Lake, Inc. is (715) 349-2910.
- Does Indianhead Medical Center Shell Lake, Inc. accept Medicare?
- Indianhead Medical Center Shell Lake, Inc. is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Indianhead Medical Center Shell Lake, Inc.?
- The authorized official listed on Indianhead Medical Center Shell Lake, Inc.'s NPPES record is Shannon Jack, Executive Vice President. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Indianhead Medical Center Shell Lake, Inc.'s NPI active?
- Yes — Indianhead Medical Center Shell Lake, Inc.'s NPI (1053859058) is active in the NPPES registry as of the last update on 2020-03-09.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.