NPIMap

Individual provider Active NPI

Jon C Older, DO

  • Internal Medicine Physician
  • Houlton, ME
National Provider Identifier
1073582128
Registry record updated May 4, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
DO1652 Issued in ME
Practice address
20 Hartford St
Houlton, ME 04730-1891
Phone
(207) 532-2900
Fax
(207) 532-5974
NPI assigned
Mar 14, 2006
Last updated
May 4, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 4, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X DO1652 ME Primary

Addresses

Primary practice location

20 Hartford St
Houlton, ME 04730-1891

Mailing address

20 Hartford St
Houlton, ME 04730-1891
Phone (207) 532-2900

Other identifiers 1

IdentifierTypeStateIssuer
323250099MedicaidME

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050906000055 ME Practitioner - Internal Medicine 0941232573 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of New England, College of Osteo Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mount Desert Island HospitalGroup PAC ID 0941250963, 61 clinicians
Houlton Regional HospitalGroup PAC ID 0042127946, shared by 5 NPIs, 59 clinicians

Practice addresses (Care Compare)

10 Wayman LN
Bar Harbor, ME 04609-1625
Phone (207) 288-5081

20 Hartford St
Houlton, ME 04730-1891
Phone (207) 532-2900

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Houlton Regional Hospital CurrentSince Jun 3, 2000 Accepting new patients
Houlton Regional Hospital CurrentSince Jun 3, 2000 Accepting new patients
Houlton Regional Hospital CurrentSince Dec 1, 2025 Accepting new patients
Mount Desert Island Hospital CurrentSince May 1, 2025 Accepting new patients
Mount Desert Island Hospital Past Accepting new patients
East Grand Health Center, Inc Past Accepting new patients

Locations

10 Wayman Ln
Bar Harbor, ME 04609
Phone (207) 288-5082

322 Main St
Bar Harbor, ME 04609
Phone (207) 288-5082

20 Hartford St
Houlton, ME 04730
Phone (207) 532-2900

22 Hartford St
Houlton, ME 04730
Phone (207) 532-3289

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/b5eba017-85d4-4b6c-a2f0-9b2c7b0c38dd/

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1142294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493856000000",
    "number": "1073582128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 HARTFORD ST",
            "city": "HOULTON",
            "state": "ME",
            "postal_code": "047301891",
            "telephone_number": "207-532-2900",
            "fax_number": "207-532-5974"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 HARTFORD ST",
            "city": "HOULTON",
            "state": "ME",
            "postal_code": "047301891",
            "telephone_number": "207-532-2900",
            "fax_number": "207-532-5974"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLDER",
        "first_name": "JON",
        "middle_name": "C",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-14",
        "last_updated": "2017-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "ME",
            "license": "DO1652",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "323250099",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Houlton, ME

Sources for this page

Verify at the official NPI Registry.