Independent US Healthcare Provider Directory & Public Medical Database
Deactivated NPI 1174894984 Deactivated / Inactive NPI Male Practitioner

Dr. Keith Edward Korneisel , DDS, LMT

Massage Therapist • Pinellas Park, FL

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Keith Korneisel has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date January 25, 2012
NPI Deactivation Date November 29, 2021
Total Practice Duration ~9 Years of Practice (2012 – 2021)

Professional Overview & Biography Verified Profile Summary

Dr. Keith Korneisel, DDS, LMT was a registered Massage Therapist practicing in Pinellas Park, FL. Throughout an active medical career spanning 9 years, Dr. Korneisel provided care at the practice location at 6447 PARK BLVD N until profile deactivation on 2021-11-29.

Practice Location & Contact Primary Location

Practice Address

6447 Park Blvd N
Suite 3

Pinellas Park, FL 337813139

Telephone 7275416323

Specialty Benchmarks & Practice Insights

Comparative analytics for Massage Therapist in Pinellas Park, FL

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 6.8 Yrs
Regional Practice Density
22 Specialists

Practicing in Pinellas Park, FL (7145 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Massage Therapist Primary Specialty

NUCC Taxonomy Code: 225700000X

State License FL MA0004241

An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes.

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated November 29, 2021

Record deactivated on November 29, 2021

NPI Profile Active January 25, 2012

NPI status registered as active in NPPES database

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Updated Practice Location January 25, 2012

Registered at 6447 PARK BLVD N, SUITE 3, PINELLAS PARK, FL 337813139 (Tel: 7275416323)

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Updated Business Mailing Address January 25, 2012

Registered at 420 48TH ST N, ST PETERSBURG, FL 337137240 (Tel: 7276420380)

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Provider Name / Credentials Updated January 25, 2012

Recorded as KEITH KORNEISEL, DDS, LMT

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Medical Taxonomy / Specialty Registered (Primary Specialty) January 25, 2012

Massage Therapist (License #MA0004241 in FL)

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Initial NPI Registration & Enumeration January 25, 2012

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1174894984
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: January 25, 2012
Last Update: January 25, 2012
Deactivation Date: November 29, 2021

Mailing Address

420 48th St N

St Petersburg, FL 337137240

Phone: 7276420380

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.