Individual provider Active NPI

Hailey Rae Rueth, COTA

  • Occupational Therapy Assistant
  • Kenosha, WI
National Provider Identifier
1538042775
Registry record updated Jul 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
7248-27 Issued in WI
Practice address
3415 Sheridan Rd
Kenosha, WI 53140-1924
Phone
(262) 657-6175
NPI assigned
Jul 28, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 7248-27 WI Primary

Addresses

Primary practice location

3415 Sheridan Rd
Kenosha, WI 53140-1924

Mailing address

4200 S Lake Dr Unit 357
Saint Francis, WI 53235-5969
Phone (715) 937-8858

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
7248-27WIMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1753660800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753660800000",
    "number": "1538042775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4200 S LAKE DR UNIT 357",
            "city": "SAINT FRANCIS",
            "state": "WI",
            "postal_code": "532355969",
            "telephone_number": "715-937-8858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3415 SHERIDAN RD",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531401924",
            "telephone_number": "262-657-6175"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUETH",
        "first_name": "HAILEY",
        "middle_name": "RAE",
        "credential": "COTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-07-28",
        "last_updated": "2025-07-28",
        "certification_date": "2025-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "WI",
            "license": "7248-27",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kenosha, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.