Active NPI
Autumn Ikimi
- Pharmacist
- Texas, TX
National Provider Identifier
1396464780
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 75643
- Practice address
- 6360 San Felipe St
Houston
Texas, TX 77057 - Phone
- (713) 278-2616
- NPI assigned
- Aug 26, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Pharmacist | 183500000X | 75643 | TX | Primary |
Addresses
Primary practice location
6360 San Felipe St
Houston
Texas, TX 77057
Mailing address
3100 Cleburne St
Houston, TX 77004-4501
Other practice location 1
3100 Cleburne St
Houston, TX 77004-4501
Phone (832) 430-0031
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
| License | State | Type | Specialty |
|---|---|---|---|
| 75643 | TX | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | Past | 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": "1661472000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1754352000000",
"number": "1396464780",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3100 CLEBURNE ST",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770044501"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6360 SAN FELIPE ST",
"address_2": "HOUSTON",
"city": "TEXAS",
"state": "TX",
"postal_code": "77057",
"telephone_number": "713-278-2616"
}
],
"practiceLocations": [
{
"address_1": "3100 Cleburne St",
"address_purpose": "LOCATION",
"city": "Houston",
"state": "TX",
"postal_code": "770044501",
"country_code": "US",
"telephone_number": "832-430-0031",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "IKIMI",
"first_name": "AUTUMN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-08-26",
"last_updated": "2025-08-05",
"certification_date": "2025-07-29",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "TX",
"license": "75643",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Texas, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 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.