Shellia Anne Kornegay, APN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

AO3247 Issued in AR

Practice address

1600 W Holland Ave Ste 202
White Hall, AR 71602-9221

Phone

(870) 619-4451

Fax

(870) 247-7089

NPI assigned

Jul 20, 2009

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Southeast Arkansas Emergency Physicians LLPGroup PAC ID 6204146319, 17 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Jefferson Regional Medical Center Hospital, Pine Bluff, AR, CCN 040071

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Southeast Arkansas Emergency Physicians LLP

  • Emergency Medicine Physician
  • Pine Bluff, AR
  • NPI 1922475078
  Medicare reassignment Care Compare group NPD
• Jefferson Hospital Association, Inc

  • Clinic/Center
  • Pine Bluff, AR
  • NPI 1841235868
  Medicare reassignment NPD
• Jefferson Hospital Association, Inc

  • Pulmonary Disease Physician
  • Pine Bluff, AR
  • NPI 1932157674
  Medicare reassignment NPD
• Jefferson Hospital Association, Inc

  • Rural Health Clinic/Center
  • Crossett, AR
  • NPI 1225799646
  NPD
• Southeast Arkansas Emergency Physicians LLP

  • Emergency Medicine Physician
  • Pine Bluff, AR
  • NPI 1467817411
  NPD
• Conway Regional Medical Center Inc

  • General Acute Care Hospital
  • Conway, AR
  • NPI 1497770424
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Jefferson Hospital Association Inc

  • General Acute Care Hospital
  • Pine Bluff, AR
  • NPI 1710931985
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1248048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783555200000",
    "number": "1124258553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 497",
            "city": "AUGUSTA",
            "state": "AR",
            "postal_code": "720060497",
            "telephone_number": "870-347-2534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 W HOLLAND AVE STE 202",
            "city": "WHITE HALL",
            "state": "AR",
            "postal_code": "716029221",
            "telephone_number": "870-619-4451",
            "fax_number": "870-247-7089"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1515 west 42nd street",
            "address_purpose": "LOCATION",
            "city": "Pine Bluff",
            "state": "AR",
            "postal_code": "71602",
            "country_code": "US",
            "telephone_number": "870-541-7111",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KORNEGAY",
        "first_name": "SHELLIA",
        "middle_name": "ANNE",
        "name_prefix": "Mrs.",
        "credential": "APN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-07-20",
        "last_updated": "2026-07-09",
        "certification_date": "2026-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AR",
            "license": "AO3247",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "180128758",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sally Kalkbrenner
• Ghulam Mohammed Khaleel, MD
• James Bradford Kimbrell, LMSW
• Bradley King, MHPP
• Mary Kling, MHPP
• Ngoc Anh Luu Le, PTA
• Lee a. Davis, Jr, MD, PA
• Life Is Beautiful Therapeutic Services, LLC
• Lincare Inc
• Love 2 Live Home Care LLC

• Family Nurse Practitioner in White Hall, AR
• Providers in White Hall, AR by specialty
• Family Nurse Practitioner in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.