NPI age
19 years
Enumerated 2007-03-28
● Active
Type 1 · Individual
Kenneth Todd Blackner, M.D.
Blackner is 1 of 1 general practice providers in Shelley and 1 of 75 in Idaho.
Primary specialty
General Practice
Plus 1 subspecialty
Licensed in
ID, VA
2 states
Status
Active
No deactivations on record
Last NPPES update
2016-02-03
Source: monthly bulk 2026-05
Sole proprietor
Yes
Solo practice on file
How this provider compares
Across 75 active general practice providers in Idaho.
NPI age
19 years
↑ 6 yr above median (13 yr)
State licenses
2 states
Top 94% — 5% of peers are multi-state
Subspecialties
0
22% of peers hold subspecialties
NPI lifetime · 2007 → 2026
2007-03Enumerated in NPPES
2007
2026
Where they practice
Practice location
275 W Locust St
Shelley, ID 832741230
Mailing address
618 E 1450 N
Shelley, ID 832745078
Specialties
-
General Practice PrimaryA physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions.
Practice context
Part of a multi-provider practice. 2 other active providers share this practice address in NPPES.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
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