Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mr. John C. Gullage, PA-C

Individual provider Surgical Physician Assistant · NPI 1558399923

Mr. John C. Gullage, PA-C is a Physician Assistant in Lebanon, Missouri. Qualified in 1987, 39 years ago. Practices with Lake Regional Health System, a 131-clinician group, works from 4 locations and accepts Medicare assignment. Licensed in Missouri, Nebraska and Washington.

Years since qualifying
39
Licensed in
MO, NE, WA
In the registry since
2006
Specialties on file
3
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

See every abbreviation used in this directory →

Practice location Address checks out

331 Hospital Dr Ste A
Lebanon, MO 65536-9251
Phone: (417) 533-6560
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (3)

  • 3050 E River Bluff Blvd, Ozark, MO 65721-8807 — (417) 820-5610
  • 608 Old Route 66, Saint Robert, MO 65584-3730 — (573) 336-2351
  • 9730 3rd Ave Ne Ste 201, Seattle, WA 98115-2023 — (206) 526-8444

Specialties & licences

Surgical Physician Assistant (primary) Taxonomy 363AS0400X · Licence 2013029322 (MO)
Surgical Physician Assistant Taxonomy 363AS0400X · Licence PA10002052 (WA)
Surgical Physician Assistant Taxonomy 363AS0400X · Licence 1999 (NE)

Record details

NPI number1558399923
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedJune 28, 2006
Last updated in NPPESMarch 17, 2021
Certification dateMarch 17, 2021

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 1987 (39 years in practice)
Group practice Lake Regional Health System — 131 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare