Individual provider Active NPI

Kelsey Dillenburg, PNP

  • Nurse Practitioner
  • Austin, TX
National Provider Identifier
1588118939
Registry record updated Jun 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
AP132631 Issued in TX
Practice address
1301 Barbara Jordan Blvd Ste 400
Austin, TX 78723-3078
Phone
(512) 708-1234
Fax
(512) 708-4567
NPI assigned
Aug 14, 2016
Last updated
Jun 23, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 23, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X AP132631 TX Primary
Pediatric Nurse Practitioner 363LP0200X AP132631 TX
Registered Nurse 163W00000X 806561 TX
Hospitalist Physician 208M00000X AP132631 TX

Addresses

Primary practice location

1301 Barbara Jordan Blvd Ste 400
Austin, TX 78723-3078

Mailing address

1301 Barbara Jordan Blvd Ste 400
Austin, TX 78723-3078
Phone (512) 708-1234

Other practice location 1

4015 22nd Pl
Lubbock, TX 79410-1119
Phone (806) 725-0030

Other practice location 2

5202 82nd St
Lubbock, TX 79424-2823
Phone (806) 725-7337

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
I20161220001196 TX Practitioner - Nurse Practitioner 3072894633 Reassigns benefits to 4 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
806561TXMDRegistered Nurse
AP132631TXMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Covenant Medical Group Hospitalist CurrentSince Apr 1, 2023 Accepting new patients
Sound Physicians Emergency Medicine of Texas PLLC Nurse Practitioner CurrentSince Mar 3, 2025 Accepting new patients
Covenant Medical Group CurrentSince Apr 1, 2023 Accepting new patients

Locations

1275 Marvin Hancock Dr
Jasper, TX 75951
Phone (409) 384-1951

2215 Nashville Ave
Lubbock, TX 79410
Phone (806) 725-5228

4002 24th St
Lubbock, TX 79410
Phone (806) 725-0000

4015 22nd Pl
Lubbock, TX 79410
Phone (806) 725-0000

5202 82nd St
Lubbock, TX 79424
Phone (806) 701-5265

3600 Gates Blvd
Port Arthur, TX 77642
Phone (409) 985-7431

Interoperability endpoints

  • Direct secure messaging: kdillenburg2801039@oc.providencedirect.org

Organizations & group practices 5

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": "1471132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782172800000",
    "number": "1588118939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 BARBARA JORDAN BLVD STE 400",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787233078",
            "telephone_number": "512-708-1234",
            "fax_number": "512-708-4567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 BARBARA JORDAN BLVD STE 400",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787233078",
            "telephone_number": "512-708-1234",
            "fax_number": "512-708-4567"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4015 22nd Pl",
            "address_purpose": "LOCATION",
            "city": "Lubbock",
            "state": "TX",
            "postal_code": "794101119",
            "country_code": "US",
            "telephone_number": "806-725-0030",
            "fax_number": "806-725-0015",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5202 82nd St",
            "address_purpose": "LOCATION",
            "city": "Lubbock",
            "state": "TX",
            "postal_code": "794242823",
            "country_code": "US",
            "telephone_number": "806-725-7337",
            "fax_number": "806-723-7002",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DILLENBURG",
        "first_name": "KELSEY",
        "credential": "PNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-08-14",
        "last_updated": "2026-06-23",
        "certification_date": "2026-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "AP132631",
            "primary": true
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "TX",
            "license": "AP132631",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TX",
            "license": "806561",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "TX",
            "license": "AP132631",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

Verify at the official NPI Registry.