KEALY KORNITZER MD
NPI 1205407004
Student in an Organized Health Care Education/Training Program in Little Rock, AR
About Kealy Kornitzer Md NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
KEALY KORNITZER MD (NPI 1205407004) is an individual student in an organized health care education/training program in Little Rock, Arkansas and active in the NPI registry since July 2021. She is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Kealy Kornitzer Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
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.
LITTLE ROCK, AR 72205
LITTLE ROCK, AR 72205
LITTLE ROCK, AR 72205
LITTLE ROCK, AR 72205
LITTLE ROCK, AR 72205
LITTLE ROCK, AR 72205
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 Kealy Kornitzer's NPI number?
The NPI number for Kealy Kornitzer is 1205407004. It was assigned to this individual provider in the NPPES registry on July 2, 2021.
Where is Kealy Kornitzer located?
Kealy Kornitzer practices at 4301 W Markham St, Little Rock, AR 72205. The listed phone number is (501) 526-7569.
What is Kealy Kornitzer's specialty?
The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.
Is Kealy Kornitzer enrolled in Medicare?
Yes. Kealy Kornitzer is registered in the Medicare PECOS enrollment system.
When was this NPI record last updated?
The NPPES record for Kealy Kornitzer was last updated on May 6, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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.
# Kealy Kornitzer, MD · NPI 1205407004
Student in an Organized Health Care Education/Training Program provider in Little Rock, Arkansas. Individual provider, active in the CMS NPPES registry since July 2, 2021.
## Identity
- **NPI:** 1205407004 (Entity type: Individual)
- **Enumerated:** July 2, 2021
- **Primary specialty:** Student in an Organized Health Care Education/Training Program · taxonomy 390200000X
- **Sole proprietor:** No
## Practice location
- **Address:** 4301 W MARKHAM ST, Little Rock, AR 72205-7101
- **Phone:** (501) 526-7569
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
## Record status
- **NPPES last updated:** May 6, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1205407004) · Data from the CMS NPPES public registry.