NPI age
19 years
Enumerated 2007-05-02
● Active
Type 1 · Individual
DR. Blake Jeffrey Illston, D.O.
Illston is 1 of 14 emergency medicine providers in Fort Gordon and 1 of 1991 in Georgia.
Primary specialty
Emergency Medicine
Plus 1 subspecialty
Licensed in
GA
1 state
Status
Active
No deactivations on record
Last NPPES update
2023-03-29
Source: monthly bulk 2026-05
Sole proprietor
Yes
Solo practice on file
How this provider compares
Across 1991 active emergency medicine providers in Georgia.
NPI age
19 years
↑ 2 yr above median (17 yr)
State licenses
1 state
20% of peers hold multiple states
Subspecialties
1
In the 41% of peers with subspecialties
NPI lifetime · 2007 → 2026
2007-05Enumerated in NPPES
2007
2026
Where they practice
Practice location
300 W Hospital Rd
Fort Gordon, GA 309055741
Mailing address
300 W Hospital Rd
Fort Gordon, GA 309055741
Specialties
-
Emergency Medicine PrimaryAn 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....
-
Emergency MedicineAn emergency medicine physician who specializes in non-hospital based emergency medical services (e.g., disaster site, accident scene, transport vehicle, etc.) to provide pre-hospital assessment, treatment, and transport patients.
Practice context
Part of a multi-provider practice. 238 other active providers share this practice address in NPPES.
Provyx · Custom healthcare lists
Need all 1991 Emergency Medicine providers in Georgia?
Provyx verifies the list to your scope. Business emails and direct lines are looked up at delivery, validated, and not stored.
Request a quote →How to verify this provider
- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
- Check the state license is currently active.State licensing boards publish current status; NPPES does not.
- Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.