Annie Kathryn Kornetzke, DO
NPI 1053979948ActiveIndividual· Family Medicine· Taylorsville, UT
Family Medicine (DO) in Taylorsville, Utah, trained at Chicago College of Osteopathy (class of 2019). Part D covered 103 prescriptions written in 2024, 63% of them generic.
Overview
| NPI | 1053979948 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | DO |
| Sole proprietor | No |
| NPI issued | Jun 5, 2019 |
| Last updated in NPPES | Jul 19, 2022 |
| Certified by provider | Jul 19, 2022 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Family Medicine Primary | 207Q00000X | 12784879-1204 | UT |
| Student in an Organized Health Care Education/Training Program | 390200000X | 125074527 | IL |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Family Practice (UT) |
|---|
Part D prescriptions in 2024
| Prescriptions (claims) | 103 · 254 30-day fills |
|---|---|
| Patients | 20 |
| Total drug cost | $35,379 |
| Generic share | 63% of claims |
Education and affiliations
| Medical school | Chicago College of Osteopathy |
|---|---|
| Graduation year | 2019 |
| Medicare specialty | Family Practice |
Medical group
- Community Health Centers IncMidvale, UT · 39 clinicians
Industry payments (Open Payments)
None reported for 2025 or 2024.
Receiving payments does not imply wrongdoing. What Open Payments covers ·original records
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