Individual provider Active NPI

Autumn Lebakken, FNP-C

  • Nurse Practitioner
  • Houston, TX
National Provider Identifier
1396677514
Registry record updated Jun 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
1221569 Issued in TX
Practice address
1724 Richmond Ave
Houston, TX 77098-3604
Phone
(832) 818-3900
NPI assigned
Jun 1, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 1221569 TX Primary

Addresses

Primary practice location

1724 Richmond Ave
Houston, TX 77098-3604

Mailing address

1724 Richmond Ave
Houston, TX 77098-3604
Phone (832) 818-3900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2429 Bissonnet St
Suite 566
Houston, TX 77005-1451

PO Box
Suite 1106
Granbury, TX 76048

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1221569TXMDNurse Practitioner

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1780272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780272000000",
    "number": "1396677514",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1724 RICHMOND AVE",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770983604",
            "telephone_number": "832-818-3900",
            "fax_number": "858-667-6635"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1724 RICHMOND AVE",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770983604",
            "telephone_number": "832-818-3900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEBAKKEN",
        "first_name": "AUTUMN",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-06-01",
        "last_updated": "2026-06-01",
        "certification_date": "2026-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "1221569",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.