Annie Kornetzke, DO
NPI 1053979948 · Family Medicine Physician · Taylorsville, UT
Enrolled with Medicare as Practitioner - Family Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Annie Kornetzke, DO is a Family Medicine Physician provider in Taylorsville, UT (NPI 1053979948).
Provider details
- NPI number
- 1053979948
- Entity type
- Individual
- Primary specialty
- Family Medicine PhysicianAllopathic & Osteopathic Physicians
- Credential
- DO
- Sex
- Female
- Sole proprietor
- No
- License
- 125074527 (IL)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Student, Health Care
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
7 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2019-06-05
- Last updated
- 2022-07-19
- Certified
- 2022-07-19
Frequently asked questions
- What is Annie Kornetzke's NPI number?
- Annie Kornetzke's National Provider Identifier (NPI) is 1053979948, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Annie Kornetzke's specialty?
- Annie Kornetzke is listed in the NPPES registry with a primary specialty of Family Medicine Physician (Allopathic & Osteopathic Physicians).
- Where is Annie Kornetzke located?
- Annie Kornetzke's practice location on file with NPPES is 4745 S 3200 W, Taylorsville, UT 84129-2822.
- What is Annie Kornetzke's phone number?
- The practice phone number listed in the NPPES registry for Annie Kornetzke is (801) 964-6214.
- Does Annie Kornetzke accept Medicare?
- Annie Kornetzke is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Is Annie Kornetzke's NPI active?
- Yes — Annie Kornetzke's NPI (1053979948) is active in the NPPES registry as of the last update on 2022-07-19.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.