Individual provider Active NPI

Autumn Lewis, MSN

  • Nurse Practitioner
  • San Antonio, TX
National Provider Identifier
1952046658
Registry record updated Feb 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APRN1073167 Issued in TX
Practice address
525 Oak Centre Dr Ste 140
San Antonio, TX 78258-3916
Phone
(210) 504-3056
NPI assigned
Apr 28, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2024

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 APRN1073167 TX Primary

Addresses

Primary practice location

525 Oak Centre Dr Ste 140
San Antonio, TX 78258-3916

Mailing address

3551 Roger Brooke Dr
Fort Sam Houston, TX 78234-4504

Other practice location 1

6051 Fm 3009 Ste 210
Schertz, TX 78154-3473
Phone (210) 299-7770

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231011002067 TX Order and Referring Only - Nurse Practitioner 2062893902

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APRN1073167TXMDNurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1651104000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709078400000",
    "number": "1952046658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3551 ROGER BROOKE DR",
            "city": "FORT SAM HOUSTON",
            "state": "TX",
            "postal_code": "782344504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 OAK CENTRE DR STE 140",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782583916",
            "telephone_number": "210-504-3056"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6051 Fm 3009 Ste 210",
            "address_purpose": "LOCATION",
            "city": "Schertz",
            "state": "TX",
            "postal_code": "781543473",
            "country_code": "US",
            "telephone_number": "210-299-7770",
            "fax_number": "210-545-3671",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "AUTUMN",
        "credential": "MSN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-28",
        "last_updated": "2024-02-28",
        "certification_date": "2024-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "APRN1073167",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.