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KEVIN K. NIEBAUM D.O.
NPI 1760449383
Pediatrics in Jacksonville, FL

Active since April 27, 2006
2080 CHILD ST, JACKSONVILLE, FL 32214(904) 542-9703(904) 542-9483 Get Directions Write a Review

NPPES record last updated: February 6, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Kevin K. Niebaum D.o. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KEVIN K. NIEBAUM D.O. (NPI 1760449383) is an individual pediatrics provider in Jacksonville, Florida, licensed in Georgia (047353) and active in the NPI registry since April 2006.

NPPES Registry Identity

NPI1760449383
Entity TypeIndividualMale
Primary Taxonomy208000000X
Provider Legal NameKEVIN K. NIEBAUMCredential: D.O.
Location Address2080 CHILD STJacksonville, FL 32214-3647
Mailing Address2080 Child StJacksonville, FL 32214-3600 · (904) 542-9703 · Fax (904) 542-9483
Phone(904) 542-9703
Fax(904) 542-9483
Sole ProprietorYes
Enumeration DateApril 27, 2006
Last NPPES UpdateFebruary 6, 2025
NPPES CertifiedFebruary 6, 2025
✔ NPI 1760449383 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
License✔ Licensed in GA · 047353
Definition
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
2080 CHILD ST, Jacksonville, FL 32214
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Other Identifiers 1

Medicaid000834809DGA

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MR. STEVEN LEE UNDHEIM IDC
Military Health Care Provider (Independent Duty Corpsman)
2080 CHILD ST
JACKSONVILLE, FL 32214
Duval County (904) 546-7094
RAMONA GREENE
Registered Nurse (Medical-Surgical)
2080 CHILD ST
JACKSONVILLE, FL 32214
Duval County (904) 542-7300
DR. HANNAH GOULD MD
Military Health Care Provider
2080 CHILD ST
JACKSONVILLE, FL 32214
Duval County (904) 542-7762
DR. RONALD APPLEBY D.M.D
Dentist (General Practice)
2080 CHILD ST
JACKSONVILLE, FL 32214
Duval County (904) 542-3442
MS. DEBRA LYNN WAGNER CNM, ARNP
Advanced Practice Midwife
2080 CHILD ST
JACKSONVILLE, FL 32214
Duval County (904) 542-7300
DR. NICOLE MARIE THATCHER MD
General Practice
2080 CHILD ST
JACKSONVILLE, FL 32214
Duval County (904) 542-0409
MR. ROBERT NEWTON DOBBINS III RPH
Pharmacist
2080 CHILD ST
JACKSONVILLE, FL 32214
Duval County (904) 542-2537
DR. DWIGHT DAVID HART PSY.D.
Psychologist (Clinical)
2080 CHILD ST
JACKSONVILLE, FL 32214
Duval County (904) 542-3473

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kevin Niebaum's NPI number?

The NPI number for Kevin Niebaum is 1760449383. It was assigned to this individual provider in the NPPES registry on April 27, 2006.

Where is Kevin Niebaum located?

Kevin Niebaum practices at 2080 Child St, Jacksonville, FL 32214. The listed phone number is (904) 542-9703.

What is Kevin Niebaum's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

When was this NPI record last updated?

The NPPES record for Kevin Niebaum was last updated on February 6, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.