Active NPI
Autumn Childress
- Physician Assistant
- Jersey City, NJ
National Provider Identifier
1669399556
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- Practice address
- 475 Communipaw Ave
Jersey City, NJ 07304-5401 - Phone
- (248) 990-8572
- NPI assigned
- Jul 1, 2026
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | Primary |
Addresses
Primary practice location
475 Communipaw Ave
Jersey City, NJ 07304-5401
Mailing address
132A Stanhope St Apt 1a
Brooklyn, NY 11221-3407
Phone (248) 990-8572
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1782864000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1786752000000",
"number": "1669399556",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "132A STANHOPE ST APT 1A",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112213407",
"telephone_number": "248-990-8572"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "475 COMMUNIPAW AVE",
"city": "JERSEY CITY",
"state": "NJ",
"postal_code": "073045401",
"telephone_number": "248-990-8572"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHILDRESS",
"first_name": "AUTUMN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2026-07-01",
"last_updated": "2026-08-15",
"certification_date": "2026-08-15",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jersey City, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 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.