Individual provider Active NPI

Blake Dallon, DO

  • Student in an Organized Health Care Education/Training Program
  • Savannah, GA
National Provider Identifier
1346944766
Registry record updated Jul 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
License
101962 Issued in GA
Practice address
601 E 66TH St
Savannah, GA 31405-4519
Phone
(912) 662-0088
Fax
(912) 216-3489
NPI assigned
Mar 29, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 101962 GA Primary

Addresses

Primary practice location

601 E 66TH St
Savannah, GA 31405-4519

Mailing address

601 E 66TH St
Savannah, GA 31405-4519
Phone (912) 662-0088

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241121004149 GA Practitioner - Psychiatry 3577098987 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gateway Community Service BoardGroup PAC ID 3173510237, 42 clinicians

Practice addresses (Care Compare)

600 Coastal Village Dr
Brunswick, GA 31520-1973
Phone (912) 554-8000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
101962GAMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Gateway Behavioral Health Services CurrentSince Oct 1, 2024 Accepting new patients
Gateway Community Service Board CurrentSince Oct 1, 2024 Accepting new patients

Locations

700 Coastal Village Dr
Brunswick, GA 31520
Phone (912) 554-8400

600 Coastal Village Dr
Brunswick, GA 31520
Phone (912) 449-7111

1113 E Oglethorpe Hwy
Hinesville, GA 31313
Phone (912) 280-7023

124 SW Broad St
Jesup, GA 31545
Phone (912) 280-7023

601 E 66th St
Savannah, GA 31405
Phone (912) 503-9539

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1680048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753747200000",
    "number": "1346944766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 E 66TH ST",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314054519",
            "telephone_number": "912-662-0088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 E 66TH ST",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314054519",
            "telephone_number": "912-662-0088",
            "fax_number": "912-216-3489"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DALLON",
        "first_name": "BLAKE",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-03-29",
        "last_updated": "2025-07-29",
        "certification_date": "2025-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "GA",
            "license": "101962",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Savannah, GA

Sources for this page

Verify at the official NPI Registry.