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Shell Lake Clinic, Ltd

Shell Lake Clinic, Ltd is a healthcare organization registered as Family Medicine Physician in Shell Lake, WI, holding Type 2 (organization) NPI 1083722805 since 2006. The authorized official on file is Jeffrey Dunham, President.

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NPI 1083722805
Entity type Organization (Type 2)
Legal business name Shell Lake Clinic, Ltd
Practice address 105 4TH AVE, Shell Lake, WI, 54871
Phone 7154682711
Fax 7154682727
Enumeration date 2006-08-29
Last updated in NPPES 2008-10-23

Authorized official

Name Jeffrey Dunham
Title President
Phone 7154682711

Taxonomy & classification

Taxonomy code Specialty Primary License State
207Q00000X Family Medicine Physician Primary

Other identifiers

Identifier Type State Issuer
32751100 Medicaid WI
Copy-ready billing details
Provider: Shell Lake Clinic, Ltd
NPI: 1083722805
Taxonomy: 207Q00000X (Family Medicine Physician)
Address: 105 4TH AVE, Shell Lake, WI, 54871

Providers at this address

NPI Name Type Specialty Location
1316945512 Kenneth Garrison Individual Surgery Physician Shell Lake, WI
1588737456 Kenneth J Garrison, MD, Sc Organization Surgery Physician Shell Lake, WI
1508225988 Shell Lake Clinic, Ltd Organization Family Medicine Physician Shell Lake, WI

Verify this record

Cross-check NPI 1083722805 against the authoritative CMS record: view Shell Lake Clinic, Ltd on the official NPPES registry .

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes — even if the provider moves or changes specialty. Read the full guide or validate an NPI number.

Frequently asked questions

What type of organization is Shell Lake Clinic, Ltd?
Shell Lake Clinic, Ltd is registered in NPPES as a Family Medicine Physician (its primary provider taxonomy).
What is a Type 2 NPI?
A Type 2 NPI identifies an organization (group practice, hospital, pharmacy, lab), while Type 1 NPIs identify individual providers. Organizations bill under their Type 2 NPI.

Source: CMS NPPES (public data). Snapshot 2026-07-11. Provider record last updated 2008-10-23.