INDIANHEAD MEDICAL CENTER SHELL LAKE, INC (NPI# 1568438125) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568438125 |
| Entity Type | Organization |
| Organization Name | INDIANHEAD MEDICAL CENTER SHELL LAKE, INC |
| Practice Address |
113 4th Avenue Shell Lake WI 54871 |
| Practice Telephone | 7154687833 |
| Mailing Telephone | 7154687833 |
| Enumeration Date | 2006-02-24 |
| Last Update Date | 2020-03-09 |
| Authorized Official Name | MR. SHANNON J JACK (EXECUTIVE VICE PRESIDENT) |
| Authorized Official Telephone | 7154687833 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 282NC0060X |
General Acute Care Hospital Specialization: Critical Access |
1047 | WI | Hospitals |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | INDIANHEAD MEDICAL CENTER SHELL LAKE, INC. | 113 4th Ave, Shell Lake, WI 54871-4457 |
| Street Address |
113 4TH AVENUE |
| City | SHELL LAKE |
| State | WI |
| Zip Code | 54871 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356483796 | Indianhead Medical Center Shell Lake Inc | Clinic/Center | 113 4th Avenue, Shell Lake, WI 54871 | 2007-02-13 |
| 1871500769 | Indianhead Medical Center Shell Lake Inc | Medicare Defined Swing Bed Unit | 113 4th Avenue, Shell Lake, WI 54871 | 2006-08-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841811973 | Danette Ellen Hopke | Registered Nurse | 600 E. County Highway B, Shell Lake, WI 54871 | 2020-04-29 |
| 1033574108 | Kathleen Ann Thom | Registered Nurse | 702 N. Front Street, Spooner, WI 54871 | 2015-12-16 |
| 1477951143 | Steven Michael Jacobson | Respiratory Therapist, Registered | 113 4th Ave., Shell Lake, WI 54871 | 2014-12-12 |
| 1316230972 | Ventures Unlimited, Inc. | Massage Therapist | 110 North Industrial Blvd., Shell Lake, WI 54871 | 2011-05-16 |
| 1447400189 | Linda M. Casey | Midwife | 210 8th Avenue, Shell Lake, WI 54871 | 2008-09-30 |
| 1295939049 | Premier Healthcare Management of Shell Lake LLC | Skilled Nursing Facility | 802 E Cty Hwy B, Shell Lake, WI 54871 | 2007-06-14 |
| 1134322530 | Washburn County Department of Health and Human Services | Case Management | 110 4th Ave W, Shell Lake, ID 54871 | 2007-06-06 |
| 1629110077 | Indianhead Medical Center Shell Lake Inc | Home Health | 113 Fourth Ave, Shell Lake, WI 54871 | 2007-02-13 |
| 1710046057 | Richard L Olson | Nurse Anesthetist, Certified Registered | N3171 Starkey Lake Rd., Shell Lake, WI 54871 | 2006-12-06 |
| 1275791154 | Washburn County Health and Human Services Dept | Physical Therapist | 110 4th Ave W, Shell Lake, WI 54871 | 2008-05-28 |
| Find all providers in zip 54871 | ||||
| Taxonomy Code | 282NC0060X |
| Grouping | Hospitals |
| Classification | General Acute Care Hospital |
| Specialization | Critical Access |
| Definition to come. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710333893 | Thedacare Medical Center - Waupaca, Inc. | General Acute Care Hospital | N2610 Wi 22, Waupaca, WI 54981 | 2016-05-09 |
| 1255662573 | Donald Morris Levy | General Acute Care Hospital | 4348 W Tarrytown Ln, Mequon, WI 53092-4850 | 2010-01-26 |
| 1841483112 | Club Staffing | General Acute Care Hospital | 1082 Vinyard Dr, Oregon, WI 53575-3314 | 2007-08-21 |
| 1104953090 | New Anesthesia | General Acute Care Hospital | 1236 Stillmeadow Ln, Menasha, WI 54952-8920 | 2007-02-27 |
| 1184765240 | Tomah Memorial Hospital Inc | General Acute Care Hospital | 501 Gopher Dr, Tomah, WI 54660-4513 | 2007-02-10 |
| 1194737817 | Chippewa Valley Hospital & Oakview Care Center, Inc. | General Acute Care Hospital | 1220 3rd Ave W, Durand, WI 54736-1600 | 2006-08-12 |
| 1154350049 | Edgerton Hospital and Health Services | General Acute Care Hospital | 11101 N Sherman Rd, Edgerton, WI 53534-9002 | 2006-07-02 |
| 1881640183 | Westfields Hospital, Inc. | General Acute Care Hospital | 535 Hospital Road, New Richmond, WI 54017-1449 | 2006-05-26 |
| 1053362624 | Ripon Medical Center Inc | General Acute Care Hospital | 845 Parkside Street, Ripon, WI 54971-8505 | 2006-05-16 |
| 1255382933 | Cumberland Memorial Hospital | General Acute Care Hospital | 1110 7th Ave, Cumberland, WI 54829-9133 | 2006-05-15 |
| Find all providers with the same taxonomy | ||||
| City | SHELL LAKE |
| Zip Code | 54871 |
Please comment or provide details below to improve the information on INDIANHEAD MEDICAL CENTER SHELL LAKE, INC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.