Individual provider Active NPI

Joan Mildred Wyman, COTA/L

  • Occupational Therapy Assistant
  • Las Vegas, NV
National Provider Identifier
1306076740
Registry record updated Apr 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
OTA-3693 Issued in NV
Practice address
5715 W Alexander Rd Ste 155
Las Vegas, NV 89130-2807
Phone
(702) 701-0057
Fax
(702) 701-0075
NPI assigned
Jul 20, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 15, 2026

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 OTA-3693 NV Primary

Addresses

Primary practice location

5715 W Alexander Rd Ste 155
Las Vegas, NV 89130-2807

Mailing address

5715 W Alexander Rd Ste 155
Las Vegas, NV 89130-2807
Phone (702) 701-0057

Other practice location 1

8465 W Sahara Ave Ste 111-777
Las Vegas, NV 89117-8960
Phone (702) 701-0057

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
OTA-3693NVMDOccupational Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
MCQ Lymphcare PastSince May 1, 2022 Accepting new patients
MCQ Lymphcare PastSince Dec 13, 2022 Accepting new patients

Organizations & group practices 2

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": "1248048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776211200000",
    "number": "1306076740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5715 W ALEXANDER RD STE 155",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891302807",
            "telephone_number": "702-701-0057",
            "fax_number": "702-701-0075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5715 W ALEXANDER RD STE 155",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891302807",
            "telephone_number": "702-701-0057",
            "fax_number": "702-701-0075"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8465 W Sahara Ave Ste 111-777",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891178960",
            "country_code": "US",
            "telephone_number": "702-701-0057",
            "fax_number": "702-701-0075",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WYMAN",
        "first_name": "JOAN",
        "middle_name": "MILDRED",
        "credential": "COTA/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-07-20",
        "last_updated": "2026-04-15",
        "certification_date": "2026-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "NV",
            "license": "OTA-3693",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2026; 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.