Individual provider Active NPI

Dalwinn Dale Kim, APRN, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Austin, TX
National Provider Identifier
1386236958
Registry record updated May 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
1196224 Issued in TX
Practice address
5424 W US Highway 290 Service Road
Suite 108
Austin, TX 78735
Phone
(512) 430-1130
NPI assigned
Feb 5, 2021
Last updated
May 28, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 28, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Registered NurseGroup: 193400000X SINGLE SPECIALTY GROUP 163WP0808X 960899 TX
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 1196224 TX Primary

Addresses

Primary practice location

5424 W US Highway 290 Service Road
Suite 108
Austin, TX 78735

Mailing address

2210 Lynnbrook Dr Unit 1402
Austin, TX 78748-2537
Phone (210) 660-0255

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
960899TXMDPsychiatric/Mental Health Registered Nurse
1196224TXMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
J&J Psychiatric Associates LLP Single Specialty CurrentSince Jun 3, 2025 Accepting new patients
Greater Austin Psychiatry & Wellness PLLC Single Specialty PastSince Jun 3, 2025 Accepting new patients

Locations

5424 W Highway 290
Ste 108
Austin, TX 78735
Phone (512) 430-1130

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1612483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748390400000",
    "number": "1386236958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2210 LYNNBROOK DR UNIT 1402",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787482537",
            "telephone_number": "210-660-0255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5424 W US HIGHWAY 290 SERVICE ROAD",
            "address_2": "SUITE 108",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "78735",
            "telephone_number": "512-430-1130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "DALWINN",
        "middle_name": "DALE",
        "credential": "APRN, PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-02-05",
        "last_updated": "2025-05-28",
        "certification_date": "2025-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "TX",
            "license": "960899",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "1196224",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 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.

Verify at the official NPI Registry.