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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

DR. BLAKE JEFFREY ILLSTON D.O.
NPI 1487876355
Emergency Medicine in Fort Gordon, GA

Active since May 02, 2007PECOS Enrolled
300 W HOSPITAL RD, FORT GORDON, GA 30905(706) 787-9285 Get Directions Write a Review

NPPES record last updated: July 29, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jul 29, 2026, Mar 29, 2023, Dec 4, 2019 (3 updates tracked since 2019).

About Dr. Blake Jeffrey Illston D.o. NPPES

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

DR. BLAKE JEFFREY ILLSTON D.O. (NPI 1487876355) is an individual emergency medicine provider in Fort Gordon, Georgia, licensed in Georgia (68035) and active in the NPI registry since May 2007. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1487876355
Entity TypeIndividualMale
Primary Taxonomy207P00000X
Provider Legal NameDR. BLAKE JEFFREY ILLSTONCredential: D.O.
Location Address300 W HOSPITAL RDFort Gordon, GA 30905-5741
Mailing Address300 W Hospital RdFort Gordon, GA 30905-5741 · (706) 787-9285
Phone(706) 787-9285
Sole ProprietorNo
Enumeration DateMay 2, 2007
Last NPPES UpdateJuly 29, 20263 updates tracked since enumeration
NPPES CertifiedJuly 29, 2026
✔ NPI 1487876355 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyEmergency MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207P00000X
License✔ Licensed in GA · 68035
Definition
An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury.
Also ListedEmergency Medicine · Emergency Medical ServicesTaxonomy 207PE0004X · License RTP001882 (GA)
300 W HOSPITAL RD, Fort Gordon, GA 30905
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Blake Jeffrey Illston D.o. 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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 30905 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$83.23 typical visit price
range $53.31 – $164.04
Typical copayment $20.80 (range $13.32 – $41.01)
Most-billed visit code 99203
Established Patient
$94.84 typical visit price
range $16.68 – $133.24
Typical copayment $23.71 (range $4.17 – $33.31)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

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

DR. SCOTT WILLIAM BOYER P.T., DPT, OCS
Physical Therapist
300 W HOSPITAL RD
FORT GORDON, GA 30905
Richmond County (706) 787-1024
MS. JANIS C RAYNOR LCSW
Social Worker (Clinical)
300 W HOSPITAL RD, DDEAMC
FORT GORDON, GA 30905
Richmond County (706) 787-9186
DR. LEO MORRIS JOSEPH MD
Internal Medicine
300 W HOSPITAL RD
FORT GORDON, GA 30905
Richmond County (706) 787-2720
DANA JENKINS FNP
Nurse Practitioner (Adult Health)
300 W HOSPITAL RD, CONNELLY HEALTH CLINIC
FORT GORDON, GA 30905
Richmond County (706) 787-5161
DR. GREGORY J SENGSTOCK MD PHD
Psychiatry & Neurology (Vascular Neurology)
300 W HOSPITAL RD
FORT GORDON, GA 30905
Richmond County (706) 787-1335
DWIGHT D. EISENHOWER HOSPITAL, FORT GORDON
Military Hospital
300 W HOSPITAL RD
FORT GORDON, GA 30905
Richmond County (706) 787-2920
NEELY HUDSON PHARM.D.
Pharmacist
300 W HOSPITAL RD
FORT GORDON, GA 30905
Richmond County (706) 787-5811
BRENDA CLEVELAND
Registered Nurse (Pain Management)
300 W HOSPITAL RD
FORT GORDON, GA 30905
Richmond County (706) 787-2552

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 Blake Illston's NPI number?

The NPI number for Blake Illston is 1487876355. It was assigned to this individual provider in the NPPES registry on May 2, 2007.

Where is Blake Illston located?

Blake Illston practices at 300 W Hospital Rd, Fort Gordon, GA 30905. The listed phone number is (706) 787-9285.

What is Blake Illston's specialty?

The primary specialty registered for this NPI is Emergency Medicine with taxonomy code 207P00000X.

Is Blake Illston enrolled in Medicare?

Yes. Blake Illston is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Blake Illston was last updated on July 29, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 days 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.