NPIMap

Organization Active NPI

Houlton Regional Hospital

Doing business as Houlton Family Practice

  • Rural Health Clinic/Center
  • Houlton, ME
National Provider Identifier
1386601524
Registry record updated Aug 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
HOULTON REGIONAL HOSPITAL
Doing business as
Houlton Family Practice
Practice address
22 Hartford St
Houlton, ME 04730-1898
Phone
(207) 532-3289
Fax
(207) 532-6071
NPI assigned
May 1, 2006
Last updated
Aug 21, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2025

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

Authorized official

Name
Mr. Jeff Zewe
Title
Ceo
Phone
(207) 521-2152

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X ME Primary

Addresses

Primary practice location

22 Hartford St
Houlton, ME 04730-1898

Mailing address

20 Hartford St
Houlton, ME 04730-1891
Phone (207) 532-3289

Other identifiers 1

IdentifierTypeStateIssuer
167890200MedicaidME

Other names 1

  • Houlton Family Practice Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040123000218 ME Part A Provider - Rural Health Clinic 0042127946 Practice locations: Houlton, ME

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1386601524. Details of each certification follow.

Rural health clinic certification: CCN 208501

Legal name
HOULTON REGIONAL HOSPITAL
Doing business as
HOULTON FAMILY PRACTICE
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Feb 1, 2004
Last certification
Mar 9, 2016
Ownership / control type
2B
Organization structure
CorporationNon-profit
Incorporated
Feb 19, 1972 in ME
Enrollment address
22 Hartford St
Houlton, ME 04730-1844
Related CCNs
201308

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 4

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
20D0921324Houlton Family Practice22 Hartford St, Houlton, ME 04730Provider-performed microscopyOct 23, 2026

National Provider Directory

National Provider Directory
Tax ID family
Katahdin Valley Health3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 14

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Shauna M Cameron Individual Corporate OfficerChief Executive Officer Jan 1, 2024
Nancy Ketch Individual Corporate Director Nov 14, 2007
Clara Regina Brown Individual Corporate OfficerChief Operations Officer Nov 1, 2023
Gary Bossie Individual Corporate Director Mar 1, 2012
Thomas Moakler Individual Corporate OfficerCeo Jul 1, 1996
Corporate DirectorCeo Jan 23, 2004
Operational/Managerial ControlCeo Sep 3, 1996
Hassan Abouleish Individual Corporate Director Nov 14, 2007
Brian S Griffin Individual Corporate OfficerChief Medical Officer Nov 1, 2023
Corporate Director Jan 1, 2011
Scott Allen Individual Corporate Director Mar 1, 2018
Douglas Hazlett Individual Corporate Director Jun 1, 2011
Karl Philip Woods Individual Corporate Director Mar 1, 2012
Ellen Halliday Individual Corporate Director Apr 1, 2019
Lynette McLaughlin Individual Corporate Director Nov 14, 2007
Solomon B Olabiyi Individual Corporate Director Mar 1, 2017
Max Lynds Individual Corporate Director Nov 14, 2007

Owners & managing parties with NPI records 4

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1146441600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1755734400000",
    "number": "1386601524",
    "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": "207-532-3289",
            "fax_number": "207-532-6071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 HARTFORD ST",
            "city": "HOULTON",
            "state": "ME",
            "postal_code": "047301898",
            "telephone_number": "207-532-3289",
            "fax_number": "207-532-6071"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOULTON REGIONAL HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-01",
        "last_updated": "2025-08-21",
        "certification_date": "2025-08-21",
        "status": "A",
        "authorized_official_last_name": "ZEWE",
        "authorized_official_first_name": "JEFF",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "207-521-2152",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "ME",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "167890200",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Houlton Family Practice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Houlton, ME

Sources for this page

Verify at the official NPI Registry.