CMS-1500 Box 24J / 33a • NPI
1982188389
Type 1 Individual Rendering/Ordering
HIPAA NUCC Taxonomy • CMS Code
363L00000X (CMS 50)
Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner
Box 32 Service Location & ZIP+4
2630 STATE HIGHWAY K, OFALLON, MO, 63368
Official NPPES Practice Location
✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR:
NPI
1982188389 (MARY WITHOELTER, Nurse Practitioner) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).
CMS Medicare Order & Referring PECOS Eligibility
Medicare Part B
✓ Eligible
DMEPOS Ordering
✓ Eligible
Home Health (HHA)
✓ Eligible
Power Mobility
✓ Eligible
Hospice Referring
No
Empirical CMS Medicare Claims, CPT Utilization & Part D Prescribing (NPI #1982188389)
Medicare Beneficiaries
247
Total Billed Services
2,206
Distinct CPT/HCPCS Codes
109
Medicare Allowed Total
$48,812.67
Actual Top Billed CPT / HCPCS Procedures (CMS Part B)
| CPT / HCPCS | Clinical Procedure Description | Services |
|---|---|---|
71046 | X-ray of chest, 2 views | 45 |
80051 | Blood test panel for electrolytes (sodium potassium, chloride, carbon dioxide) | 37 |
81003 | Automated urinalysis test | 45 |
82040 | Albumin (protein) level | 15 |
82150 | Amylase (enzyme) level | 15 |
82247 | Bilirubin level, total | 15 |
82550 | Creatine kinase (cardiac enzyme) level, total | 34 |
82565 | Blood creatinine level | 33 |
Actual Top Prescribed Medications (CMS Part D)
| Brand / Generic Medication | Total Claims | Patients |
|---|---|---|
| Albuterol Sulfate Hfa Albuterol Sulfate | 23 | 23 |
| Amoxicillin-Clavulanate Potass Amoxicillin/Potassium Clav | 18 | 18 |
| Azithromycin Azithromycin | 26 | 26 |
| Cephalexin Cephalexin | 25 | 25 |
| Doxycycline Monohydrate Doxycycline Monohydrate | 39 | 39 |
| Methocarbamol Methocarbamol | 11 | 11 |
| Prednisone Prednisone | 101 | 100 |
Official CMS NPPES Credential & Practice Profile
| 10-Digit NPI Number | 1982188389 (NPI-1 Individual Practitioner) |
|---|---|
| Provider / Legal Name | MARY WITHOELTER, Nurse Practitioner |
| Plain-English Specialty | Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner NUCC Code: 363L00000X (Nurse Practitioner) |
| Certifying / Licensing Body | State Medical / Healthcare Licensing Board & National Specialty Board |
| Practice Location Address | 2630 STATE HIGHWAY K, OFALLON, MO, 63368 |
| Practice Telephone / Fax | Tel: (636) 980-5300 | Fax: (636) 980-5344 |
| Administrative Mailing Address | PO BOX 959354, SAINT LOUIS, MO, 63195-9354 |
| Enumeration & Last Sync | Enumerated: 2018-09-20 | CMS Record Updated: 2025-09-18 |
Clinic Location, Accessibility & Directions
📍 Practice Location & Patient Access
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Plain-English Taxonomy & CMS Crosswalk (363L00000X)
What Does Taxonomy Code 363L00000X Mean?
In the HIPAA National Uniform Claim Committee (NUCC) classification, code 363L00000X translates to:
"Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner"
Specialty Clinical Procedures & Therapeutic Classes
Standard Scope of Care (MARY WITHOELTER, Nurse Practitioner)
Typical CPT / Diagnostic Procedures:- Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
- Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
- Preventive Screening, Patient Counseling & Multidisciplinary Referral
- Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)
All Registered NUCC Taxonomies & State Licenses
| Taxonomy Code & Plain-English Description | State License & Primary Status |
|---|---|
363L00000X — Nurse PractitionerPlain English: Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner | State: MO | License: 2019033706 | Primary: Yes (Primary) |
363LF0000X — Nurse Practitioner, FamilyPlain English: Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner, Family | State: MO | License: 2019033706 | Primary: Secondary |
Medical Billing, RCM & Hospital Credentialing Teams:
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