Individual provider Active NPI

Audrey Geneane Siders, DROT, OTR/L

  • Occupational Therapist
  • Las Vegas, NV
National Provider Identifier
1326437229
Registry record updated Jun 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
15-0595 Issued in NV
Practice address
5089 W Moberly Ave
Las Vegas, NV 89139-0142
Phone
(810) 280-6367
NPI assigned
Jan 15, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 16, 2026

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 15-0595 NV Primary
Occupational Therapist 225X00000X 5201007621 MI

Addresses

Primary practice location

5089 W Moberly Ave
Las Vegas, NV 89139-0142

Mailing address

5089 W Moberly Ave
Las Vegas, NV 89139-0142
Phone (810) 280-6367

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
5201007621MIMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Therapy Blocks L.L.C. Occupational Therapist 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": "1421280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781568000000",
    "number": "1326437229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5089 W MOBERLY AVE",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891390142",
            "telephone_number": "810-280-6367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5089 W MOBERLY AVE",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891390142",
            "telephone_number": "810-280-6367"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIDERS",
        "first_name": "AUDREY",
        "middle_name": "GENEANE",
        "name_prefix": "Dr.",
        "credential": "DROT, OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-01-15",
        "last_updated": "2026-06-16",
        "certification_date": "2026-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NV",
            "license": "15-0595",
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MI",
            "license": "5201007621",
            "primary": false
        }
    ],
    "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 Jun 16, 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.