All Medicaid billing entities listing JACK, SHANNON (EXECUTIVE VICE PRESIDENT) as their authorized official in the NPPES registry.
| State | Entities | Total Paid |
|---|---|---|
| Wisconsin | 3 | $658K |
| # | Provider | Location | Specialty | Total Paid |
|---|---|---|---|---|
| 1 | INDIANHEAD MEDICAL CENTER SHELL LAKE, INC | SHELL LAKE, WI | Critical Access Hospital | $501K |
| 2 | INDIANHEAD MEDICAL CENTER SHELL LAKE, INC. | SHELL LAKE, WI | Rural Health Clinic/Center | $153K |
| 3 | INDIANHEAD MEDICAL CENTER SHELL LAKE, INC. | SIREN, WI | Primary Care Clinic/Center | $4K |