KENNETH TODD BLACKNER (M.D.) – General Practice Physician, NPI 1043339641
Preparing for Medicare enrollment?
Use our CMS-855 prep checklist: which form applies (855I, 855O, or 855A), readiness score, NPPES field map, and Section 12 documents. Reassignment uses CMS-855I Section 4F—not the discontinued CMS-855R form.
Open Medicare 855 Prep tool →General Practice Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for KENNETH TODD BLACKNER (M.D.)
618 E 1450 N
SHELLEY, ID 832745078
Phone: (757) 617-3339
Type: Mailing
275 W LOCUST ST
SHELLEY, ID 832741230
Phone: (208) 357-3960
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
Loading prescription activity...
Open Payments (CMS)
CMS reports 22 Open Payments records for all available years, with a total value of $414.
Total Amount is formed as General ($414) + Research ($0) + Ownership ($0) = $414.
Last reported payment date: 2024-01-17 • Largest payer in this snapshot: Actelion Pharmaceuticals US, Inc. ($217).
Total Amount
$414
General + Research + Ownership
Payments
22
Total payment records
General Amount
$414
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-01-17
Latest reported date
Top Companies
Largest payers in this snapshot
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
No Medicare enrollment or revalidation data available for this provider in our database.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 83274)
Loading plans...
Group practice members
| Name | Specialty | State |
|---|---|---|
| N E U R O S U R G E R Y | ID | |
| O B S T E T R I C S/ G Y N E C O L O G Y | ID | |
| - | MO | |
| Physician Assistant | ID | |
| Emergency Medicine | ID | |
| O B S T E T R I C S/ G Y N E C O L O G Y | OK | |
| - | ID | |
| Family Practice | OK | |
| - | WA | |
| Orthopedic Surgery | ID |
Reviews
All reviews are moderated before publication. Reviews reflect users' opinions; we do not verify the accuracy of individual reviews.
No reviews yet. Be the first to share your experience — your opinion helps families compare providers.