Gage Pavely

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

2026042244 Issued in MO

Practice address

1870 Bagnell Dam Blvd
Lake Ozark, MO 65049-8658

Phone

(573) 365-2318

NPI assigned

Aug 31, 2026

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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

{
    "created_epoch": "1788134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788134400000",
    "number": "1669380606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "907 JASON RD",
            "city": "JEFFERSON CITY",
            "state": "MO",
            "postal_code": "651095810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1870 BAGNELL DAM BLVD",
            "city": "LAKE OZARK",
            "state": "MO",
            "postal_code": "650498658",
            "telephone_number": "573-365-2318"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "54 Hospital Dr",
            "address_purpose": "LOCATION",
            "city": "Osage Beach",
            "state": "MO",
            "postal_code": "650653050",
            "country_code": "US",
            "telephone_number": "573-348-8000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PAVELY",
        "first_name": "GAGE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-08-31",
        "last_updated": "2026-08-31",
        "certification_date": "2026-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "MO",
            "license": "2026042244",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Myers
• Virginia A Nagy, M.D.
• Cory Taylor Neusche, MA, PLPC
• Shannon L O'Connell, PLPC
• Todd P Odell, LPC
• Chanceler Pemberton
• Rebekah Sue Petras, RN
• Jeffrey L Piontek, M.D.
• Premier Dental & Oral Health Group,P.C.
• Premier Dental and Oral Health Group

• Physical Therapy Assistant in Lake Ozark, MO
• Providers in Lake Ozark, MO by specialty
• Physical Therapy Assistant in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.