Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Timothy Blackner

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1245790302

Timothy Blackner is a Family Practice in Florence, South Carolina. Qualified in 2019, 7 years ago. Practices with Providence Health and Services Washington, a 480-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Washington.

Years since qualifying
7
Licensed in
WA
In the registry since
2019
Specialties on file
2

Practice location Address checks out

Student / training record This NPI belongs to someone enrolled in a health care training programme. It carries no licence and no practice of its own, so no address or phone number is published for it.

Florence, SC

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence 1245790302 (WA)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1245790302
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedMarch 23, 2019
Last updated in NPPESJanuary 5, 2023
Certification dateJanuary 5, 2023

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyFAMILY PRACTICE
Medical schoolOTHER
Graduated 2019 (7 years in practice)
Group practice Providence Health And Services Washington — 480 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

Other providers in Florence