Individual provider Active NPI

Mary Dynis, COTA

  • Occupational Therapy Assistant
  • Las Vegas, NV
National Provider Identifier
1669162228
Registry record updated Oct 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
OTA-2805 Issued in NV
Practice address
9079 W Post Rd Ste 100
Las Vegas, NV 89148-2414
Phone
(702) 612-1535
NPI assigned
May 8, 2023
Last updated
Oct 9, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 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 OTA-2805 NV Primary

Addresses

Primary practice location

9079 W Post Rd Ste 100
Las Vegas, NV 89148-2414

Mailing address

9050 W Tropicana Ave Unit 1134
Las Vegas, NV 89147-8189
Phone (792) 612-1535

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-2805NVMDOccupational Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Speakeasy Therapy Services, LLC PastSince May 1, 2023 Accepting new patients
Speakeasy Therapy Services, LLC Occupational Therapy Assistant PastSince Aug 18, 2024 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, 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": "1683504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759968000000",
    "number": "1669162228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9050 W TROPICANA AVE UNIT 1134",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891478189",
            "telephone_number": "792-612-1535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9079 W POST RD STE 100",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891482414",
            "telephone_number": "702-612-1535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DYNIS",
        "first_name": "MARY",
        "credential": "COTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-08",
        "last_updated": "2025-10-09",
        "certification_date": "2025-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "NV",
            "license": "OTA-2805",
            "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 Oct 9, 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.