KENNETH TODD BLACKNER M.D.
NPI 1043339641
General Practice in Shelley, ID

Q: What is Kenneth Blackner's NPI number?

The NPI number for Kenneth Blackner is 1043339641. It was assigned to this individual provider in the NPPES registry on March 28, 2007.

Q: What is Kenneth Blackner's specialty?

The primary specialty registered for this NPI is General Practice with taxonomy code 208D00000X.

Q: When was this NPI record last updated?

The NPPES record for Kenneth Blackner was last updated on February 3, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 years 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.

Active since March 28, 2007PECOS Enrolled

275 W LOCUST ST, SHELLEY, ID 83274(208) 357-3960 Get Directions Write a Review

NPPES record last updated: February 3, 2016. Verified against the NPPES registry weekly; last sync: August 02, 2026.

On this page

About Kenneth Todd Blackner M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KENNETH TODD BLACKNER M.D. (NPI 1043339641) is an individual general practice provider in Shelley, Idaho, licensed in Idaho (M-11785) and active in the NPI registry since March 2007. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1043339641

Entity TypeIndividualMale

Primary Taxonomy208D00000X

Provider Legal NameKENNETH TODD BLACKNERCredential: M.D.

Location Address275 W LOCUST STShelley, ID 83274-1230

Mailing Address618 E 1450 NShelley, ID 83274-5078 · (757) 617-3339

Phone(208) 357-3960

Sole ProprietorYes

Enumeration DateMarch 28, 2007

Last NPPES UpdateFebruary 3, 2016

✔ NPI 1043339641 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyGeneral PracticeAllopathic & Osteopathic Physicians

Taxonomy Code208D00000X

Licenses✔ Licensed in ID · M-11785✔ Licensed in VA · 0101240258

Definition

A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee

275 W LOCUST ST, Shelley, ID 83274

Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Moda Health Plan, Inc., Select Health.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Kenneth Todd Blackner M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer– Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Referred Medical Equipment & Supplies CMS DME claims 5

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Full face mask used with positive airway pressure device, each A7030

DME-Other DME · category DE001N

3 suppliers12 claims12 services$106.77 avg. paid by Medicare

Portable oxygen contents, gaseous, 1 month's supply = 1 unit E0443

DME-Oxygen and Supplies · category DC000N

2 suppliers12 claims12 services$42.16 avg. paid by Medicare

Continuous positive airway pressure (cpap) device E0601

DME-Other DME · category DE001N

2 suppliers13 claims13 services$39.25 avg. paid by Medicare

Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390

DME-Oxygen and Supplies · category DC002N

1 supplier12 claims12 services$109.33 avg. paid by Medicare

Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service K0553

DME-Other DME · category DE017N

1 supplier12 claims12 services$200.12 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

BMH INC

Clinic/Center (Rural Health)

275 W LOCUST ST
SHELLEY, ID 83274

Bingham County (208) 782-2960

BINGHAM MEMORIAL HOSPITAL

Clinic/Center (Rural Health)

275 W LOCUST ST
SHELLEY, ID 83274

Bingham County (208) 785-4100

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 Kenneth Blackner's NPI number?

The NPI number for Kenneth Blackner is 1043339641. It was assigned to this individual provider in the NPPES registry on March 28, 2007.

Where is Kenneth Blackner located?

Kenneth Blackner practices at 275 W Locust St, Shelley, ID 83274. The listed phone number is (208) 357-3960.

What is Kenneth Blackner's specialty?

The primary specialty registered for this NPI is General Practice with taxonomy code 208D00000X.

Is Kenneth Blackner enrolled in Medicare?

Yes. Kenneth Blackner is registered in the Medicare PECOS enrollment system.

What insurance does Kenneth Blackner accept?

Health plans from Moda Health Plan, Inc. and Select Health list Kenneth Blackner as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Kenneth Blackner was last updated on February 3, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 years 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.