Timothy Eric Blackwell, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

PTA001092 Issued in GA

Practice address

1031 Lake Country Dr
Greensboro, GA 30642-5157

Phone

(706) 549-1663

Fax

(706) 546-8792

NPI assigned

Dec 26, 2023

Last updated

Jul 1, 2025By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Athens Orthopedic Clinic, PA

  • Orthopaedic Surgery Physician
  • Athens, GA
  • NPI 1063495299
  NPD
• Athens Orthopedic Clinic, PA

  • Orthopaedic Surgery Physician
  • Greensboro, GA
  • NPI 1104219468
  NPD

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

{
    "created_epoch": "1703548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751328000000",
    "number": "1982473419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1765 OLD WEST BROAD ST BLDG 2-200",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306062887",
            "telephone_number": "706-549-1663",
            "fax_number": "706-546-8792"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1031 LAKE COUNTRY DR",
            "city": "GREENSBORO",
            "state": "GA",
            "postal_code": "306425157",
            "telephone_number": "706-549-1663",
            "fax_number": "706-546-8792"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACKWELL",
        "first_name": "TIMOTHY",
        "middle_name": "ERIC",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-12-26",
        "last_updated": "2025-07-01",
        "certification_date": "2025-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "GA",
            "license": "PTA001092",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH #",
            "identifier": "16096608",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Karen Marie Baker, FNP
• Andrew Bennett Bartolomei, MS, RDN
• Hannah M Baynes
• Annette Jackson Benneche, LPC, M.S., M.ED.
• Benzer Pharmacy Ga1 LLC (The Pharmacy at Lake Oconee)
• Tiffany T Blake
• Liz Hunter Brack, RN
• David Christopher Bradley, D.M.D.
• Patti June Bradley, D.M.D
• George Rigo Brahn, M.D.

• Physical Therapy Assistant in Greensboro, GA
• Providers in Greensboro, GA by specialty
• Physical Therapy Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.