Active NPI
Phillip M Kibort, MD
- Pediatrics Physician
- St Paul, MN
National Provider Identifier
1487767018
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 25027
- Practice address
- 347 North Smith Avenue
Mail Stop 70 501 Childrens Hospitals and Clinics of Min
St Paul, MN 55102 - Phone
- (651) 220-6165
- Fax
- (651) 220-5147
- NPI assigned
- Aug 17, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 25027 | MN | Primary |
| Pediatric Gastroenterology Physician | 2080P0206X | 25027 | MN |
Addresses
Primary practice location
347 North Smith Avenue
Mail Stop 70 501 Childrens Hospitals and Clinics of Min
St Paul, MN 55102
Mailing address
2910 Centre Pointe Drive
35 121A Childrens Health Care
Roseville, MN 55113
Phone (651) 855-2327
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25027 | MN | MD | Pediatric Gastroenterology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155772800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1757548800000",
"number": "1487767018",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2910 CENTRE POINTE DRIVE",
"address_2": "35 121A CHILDRENS HEALTH CARE",
"city": "ROSEVILLE",
"state": "MN",
"postal_code": "55113",
"telephone_number": "651-855-2327",
"fax_number": "651-855-2310"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "347 NORTH SMITH AVENUE",
"address_2": "MAIL STOP 70 501 CHILDRENS HOSPITALS AND CLINICS OF MIN",
"city": "ST PAUL",
"state": "MN",
"postal_code": "55102",
"telephone_number": "651-220-6165",
"fax_number": "651-220-5147"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIBORT",
"first_name": "PHILLIP",
"middle_name": "M",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-17",
"last_updated": "2025-09-11",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "MN",
"license": "25027",
"primary": true
},
{
"code": "2080P0206X",
"taxonomy_group": "",
"desc": "Pediatrics, Pediatric Gastroenterology",
"state": "MN",
"license": "25027",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in St Paul, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 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.