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

Mary Withoelter, NURSEPRACTITIONER

Individual provider Nurse Practitioner · NPI 1982188389

Mary Withoelter, NURSEPRACTITIONER is a Nurse Practitioner in Ofallon, Missouri. Qualified in 2018, 8 years ago. Practices with Physician Groups Lc, a 524-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Missouri.

Years since qualifying
8
Licensed in
MO
In the registry since
2018
Specialties on file
2

Practice location Address checks out

2630 State Highway K
Ofallon, MO 63368
Phone: (636) 980-5300
Fax: (636) 980-5344
Show map & directions

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

Additional practice locations (1)

  • 9556 Manchester Rd, Saint Louis, MO 63119-1313 — (314) 373-5740

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X · Licence 2019033706 (MO)
Family Nurse Practitioner Taxonomy 363LF0000X · Licence 2019033706 (MO)

Record details

NPI number1982188389
Entity typeIndividual (Type 1)
GenderFemale
Credentials NURSEPRACTITIONER
Sole proprietorNo
NPI enumeratedSeptember 20, 2018
Last updated in NPPESSeptember 18, 2025
Certification dateSeptember 18, 2025

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2018 (8 years in practice)
Group practice Physician Groups Lc — 524 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations4 on file with Medicare

Other providers in Ofallon