Individual provider Active NPI

Jacob Arnold Rhyner, DC

  • Chiropractor
  • Medford, WI
National Provider Identifier
1053181768
Registry record updated Jan 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
6155-12 Issued in WI
Practice address
123 W State St
Medford, WI 54451-1772
Phone
(715) 748-4433
NPI assigned
Jan 3, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 6155-12 WI Primary

Addresses

Primary practice location

123 W State St
Medford, WI 54451-1772

Mailing address

W989 Wilderness Ave
Rib Lake, WI 54470-9649
Phone (210) 649-0374

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240208000877 WI Practitioner - Chiropractic 7517300353 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Sherman College of Straight Chiropractic, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Borealis Wellness Clinic LLCGroup PAC ID 8123282886, 4 clinicians

Practice addresses (Care Compare)

123 W State St
Medford, WI 54451-1736
Phone (715) 748-4433

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6155-12WIMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Borealis Wellness Clinic LLC CurrentSince Jan 3, 2024 Accepting new patients

Locations

123 W State St
Medford, WI 54451
Phone (715) 748-4312

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1704240000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704240000000",
    "number": "1053181768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "W989 WILDERNESS AVE",
            "city": "RIB LAKE",
            "state": "WI",
            "postal_code": "544709649",
            "telephone_number": "210-649-0374"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 W STATE ST",
            "city": "MEDFORD",
            "state": "WI",
            "postal_code": "544511772",
            "telephone_number": "715-748-4433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RHYNER",
        "first_name": "JACOB",
        "middle_name": "ARNOLD",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-01-03",
        "last_updated": "2024-01-03",
        "certification_date": "2023-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "6155-12",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Medford, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.