Individual provider Active NPI

Haley Ann Rought, MSOT, OTR/L

  • Occupational Therapist
  • Brookfield, WI
National Provider Identifier
1568057784
Registry record updated Apr 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
056.014088 Issued in IL
Practice address
17280 W North Ave
Brookfield, WI 53045-4366
Phone
(262) 780-0707
NPI assigned
Mar 9, 2021
Last updated
Apr 6, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 7300 WI
Occupational Therapist 225X00000X 056.014088 IL Primary

Addresses

Primary practice location

17280 W North Ave
Brookfield, WI 53045-4366

Mailing address

864 Campton Dr
Rockford, IL 61102-1058
Phone (815) 209-7004

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220613002705 WI Practitioner - Occupational Therapist in Private Practice 3971982471

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7300WIMDClinical Social Worker
056.014088ILMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Prohealth Medical Group Inc. CurrentSince Jun 1, 2022 Accepting new patients

Locations

17280 W North Ave
Brookfield, WI 53045
Phone (262) 780-0707

17280 W North Ave
Ste 104
Brookfield, WI 53045
Phone (262) 780-0707

725 American Ave
Waukesha, WI 53188
Phone (262) 544-2011

N17W24100 Riverwood Dr
Waukesha, WI 53188
Phone (262) 820-3093

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1615248000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680739200000",
    "number": "1568057784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "864 CAMPTON DR",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611021058",
            "telephone_number": "815-209-7004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17280 W NORTH AVE",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530454366",
            "telephone_number": "262-780-0707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROUGHT",
        "first_name": "HALEY",
        "middle_name": "ANN",
        "credential": "MSOT, OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-09",
        "last_updated": "2023-04-06",
        "certification_date": "2023-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WI",
            "license": "7300",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IL",
            "license": "056.014088",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brookfield, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.