Newly Listed Provider — this NPI profile has been added to the NPI registry within the last 90 days.

KEITH THOMAS WIETHAUPT
NPI 1801718788
Physician Assistant - Surgical in O Fallon, MO

Q: What is Keith Wiethaupt's NPI number?

The NPI number for Keith Wiethaupt is 1801718788. It was assigned to this individual provider in the NPPES registry on July 29, 2026.

Q: What is Keith Wiethaupt's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Surgical, with taxonomy code 363AS0400X.

Q: When was this NPI record last updated?

The NPPES record for Keith Wiethaupt was last updated on July 29, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since July 29, 2026

7827 TOWN SQUARE AVE STE 104, O FALLON, MO 63368(636) 734-0386(636) 352-4173 Get Directions Write a Review

NPPES record added: July 29, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Keith Thomas Wiethaupt NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KEITH THOMAS WIETHAUPT (NPI 1801718788) is an individual surgical provider in O Fallon, Missouri, licensed in Missouri (147974) and active in the NPI registry since July 2026.

NPPES Registry Identity

NPI1801718788

Entity TypeIndividualMale

Primary Taxonomy363AS0400X

Provider Legal NameKEITH THOMAS WIETHAUPT

Location Address7827 TOWN SQUARE AVE STE 104O Fallon, MO 63368-7199

Mailing Address7827 Town Square Ave Ste 104O Fallon, MO 63368-7199 · (636) 734-0386 · Fax (636) 352-4173

Phone(636) 734-0386

Fax(636) 352-4173

Sole ProprietorYes

Enumeration DateJuly 29, 2026

NPPES CertifiedJuly 29, 2026

✔ NPI 1801718788 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · SurgicalPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363AS0400X

License✔ Licensed in MO · 147974

7827 TOWN SQUARE AVE STE 104, O Fallon, MO 63368

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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

KATRINA STEPHENS

Registered Nurse (Registered Nurse First Assistant)

7827 TOWN SQUARE AVE STE 104
O FALLON, MO 63368

St. Charles County (314) 803-0297

JAMES W HARRIS CSFA

Physician Assistant (Surgical)

7827 TOWN SQUARE AVE STE 104
O FALLON, MO 63368

St. Charles County (636) 734-0386

JULIE HUMMEL

Physician Assistant (Surgical)

7827 TOWN SQUARE AVE STE 104
O FALLON, MO 63368

St. Charles County (636) 734-0386

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Keith Wiethaupt's NPI number?

The NPI number for Keith Wiethaupt is 1801718788. It was assigned to this individual provider in the NPPES registry on July 29, 2026.

Where is Keith Wiethaupt located?

Keith Wiethaupt practices at 7827 Town Square Ave Ste 104, O Fallon, MO 63368. The listed phone number is (636) 734-0386.

What is Keith Wiethaupt's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Surgical, with taxonomy code 363AS0400X.

When was this NPI record last updated?

The NPPES record for Keith Wiethaupt was last updated on July 29, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.