Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Kevin K. Niebaum, DO

Individual provider Pediatrics Physician · NPI 1760449383

Kevin K. Niebaum, DO is a Pediatrics Physician in Jacksonville, Florida. Practices as a sole proprietor. Licensed in Georgia.

Licensed in
GA
In the registry since
2006
What do these letters mean?
DO — Doctor of Osteopathic Medicine
A fully licensed physician, trained like an MD with additional musculoskeletal training. Equivalent practice rights in all 50 states.

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Practice location Address checks out

2080 Child St
Jacksonville, FL 32214-3647
Phone: (904) 542-9703
Fax: (904) 542-9483
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pediatrics Physician (primary) Taxonomy 208000000X · Licence 047353 (GA)

Record details

NPI number1760449383
Entity typeIndividual (Type 1)
GenderMale
Credentials DO
Sole proprietorYes
NPI enumeratedApril 27, 2006
Last updated in NPPESFebruary 6, 2025
Certification dateFebruary 6, 2025

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