Individual provider Active NPI

Noelle Beth Hauser, OTR

  • Gerontology Occupational Therapist
  • Kaukauna, WI
National Provider Identifier
1992957658
Registry record updated Oct 14, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Occupational TherapistTaxonomy code 225XG0600X
License
866-026 Issued in WI
Practice address
312 E 14TH St
Kaukauna, WI 54130-3371
Phone
(920) 766-6020
NPI assigned
Oct 14, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Occupational Therapist 225XG0600X 866-026 WI Primary

Addresses

Primary practice location

312 E 14TH St
Kaukauna, WI 54130-3371

Mailing address

W3048 Just About LN
Appleton, WI 54915-3997
Phone (920) 687-0569

Other identifiers 1

IdentifierTypeStateIssuer
40711500MedicaidWI

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
866-026WIMDGerontology Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Ascension Medical Group-Fox Valley Wisconsin, Inc Past Accepting new patients

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": "1223942400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1223942400000",
    "number": "1992957658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "W3048 JUST ABOUT LN",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549153997",
            "telephone_number": "920-687-0569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "312 E 14TH ST",
            "city": "KAUKAUNA",
            "state": "WI",
            "postal_code": "541303371",
            "telephone_number": "920-766-6020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAUSER",
        "first_name": "NOELLE",
        "middle_name": "BETH",
        "name_prefix": "Mrs.",
        "credential": "OTR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-10-14",
        "last_updated": "2008-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XG0600X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Gerontology",
            "state": "WI",
            "license": "866-026",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "40711500",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kaukauna, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2008; 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.