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WILD RIVERS CHIROPRACTIC LLC
NPI 1649831132
Chiropractor in Rice Lake, WI

Active since June 25, 2019
1801 W KNAPP ST STE 1, RICE LAKE, WI 54868(715) 234-3067(715) 234-3067 Get Directions Write a Review

NPPES record last updated: April 18, 2026. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Apr 18, 2026, Aug 14, 2019 (2 updates tracked since 2019).

About Wild Rivers Chiropractic Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

WILD RIVERS CHIROPRACTIC LLC (NPI 1649831132) is a healthcare organization registered as a chiropractor in Rice Lake, Wisconsin and active in the NPI registry since June 2019. The organization lists Jacob Jon Desantis, Owner, as its authorized official.

NPPES Registry Identity

NPI1649831132
Entity TypeOrganization
Primary Taxonomy111N00000X
Legal Business NameWILD RIVERS CHIROPRACTIC LLC
Location Address1801 W KNAPP ST STE 1Rice Lake, WI 54868-1381
Mailing Address16 W John St Ste 3Rice Lake, WI 54868-2918 · (715) 234-3067 · Fax (715) 234-3067
Phone(715) 234-3067
Fax(715) 234-3067
Organization SubpartNo
Authorized OfficialJacob Jon DesantisOwner · (715) 234-3067
Enumeration DateJune 25, 2019
Last NPPES UpdateApril 18, 20262 updates tracked since enumeration
NPPES CertifiedApril 18, 2026
✔ NPI 1649831132 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyChiropractorChiropractic Providers
Taxonomy Code111N00000X
Definition
A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems.
1801 W KNAPP ST STE 1, Rice Lake, WI 54868
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Other Identifiers 1

Medicaid1952878415WI

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, HealthPartners.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)

Wild Rivers Chiropractic Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

3

Medicare enrollment records show 3 clinicians reassign Medicare billing to Wild Rivers Chiropractic LLC, which bills Medicare for the services they deliver. Of these, 3 practice within 10 miles. They are listed nearest first.

Clinicians, nearest first (3)

Kodye Tangwall, DC
Chiropractic
NPI 1689480139
16 W JOHN ST
Rice Lake, WI 54868
(715) 234-3067
✔ Accepts Medicare2.2 mi
Michaela Booth, DC
Chiropractic
NPI 1386506913
16 W JOHN ST
Rice Lake, WI 54868
(715) 234-3067
✔ Accepts Medicare2.2 mi
Jacob Desantis
Chiropractic
NPI 1952878415
16 W JOHN ST STE 3
Rice Lake, WI 54868
(715) 205-5564
✔ Accepts Medicare2.2 mi

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 Wild Rivers Chiropractic LLC's NPI number?

The NPI number for Wild Rivers Chiropractic LLC is 1649831132. It was assigned to this organization in the NPPES registry on June 25, 2019.

Where is Wild Rivers Chiropractic LLC located?

Wild Rivers Chiropractic LLC is located at 1801 W Knapp St Ste 1, Rice Lake, WI 54868. The listed phone number is (715) 234-3067.

What is Wild Rivers Chiropractic LLC's specialty?

The primary specialty registered for this NPI is Chiropractor with taxonomy code 111N00000X.

Is Wild Rivers Chiropractic LLC enrolled in Medicare?

Yes. Wild Rivers Chiropractic LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Wild Rivers Chiropractic LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 3 clinicians, all in Chiropractic, reassign their Medicare billing to Wild Rivers Chiropractic LLC. 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, 3 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Wild Rivers Chiropractic LLC accept?

Health plans from Anthem Blue Cross and Blue Shield and HealthPartners list Wild Rivers Chiropractic LLC 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 Wild Rivers Chiropractic LLC was last updated on April 18, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 months 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.