Individual provider Active NPI

Audie Horn Jr., P.A.

  • Physician Assistant
  • Houlton, ME
National Provider Identifier
1447294822
Registry record updated Oct 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA474 Issued in ME
Practice address
11 Mill St
Houlton, ME 04730-1877
Phone
(207) 532-6523
Fax
(207) 532-3873
NPI assigned
Jun 15, 2006
Last updated
Oct 4, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA474 ME Primary
Medical Physician Assistant 363AM0700X PA474 ME

Addresses

Primary practice location

11 Mill St
Houlton, ME 04730-1877

Mailing address

180 Academy St Ste 3
Presque Isle, ME 04769-3183
Phone (207) 554-2352

Other identifiers 1

IdentifierTypeStateIssuer
1447294822MedicaidME

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070420000138 ME Practitioner - Physician Assistant 3173628096 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Aroostook Mental Health Services, Inc.Group PAC ID 8426033952, 21 clinicians
Kennebec Valley Mental Health CenterGroup PAC ID 7113829383, 68 clinicians

Practice addresses (Care Compare)

104 E Main St
Fort Kent, ME 04743-1407
Phone (207) 834-3186

11 Mill St
Houlton, ME 04730-1877
Phone (207) 532-6523

180 Academy St
Suite 2
Presque Isle, ME 04769-3183
Phone (207) 764-3319

43 Hatch Dr
Suite 310
Caribou, ME 04736-2039
Phone (207) 493-3361

67 Eustis Pkwy
Waterville, ME 04901-5173
Phone (207) 873-2136

88 Fox St
Suite 101
Madawaska, ME 04756-1352
Phone (207) 728-6341

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA474MEMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Redington-Fairview General Hospital CurrentSince May 15, 2017 Accepting new patients
East Grand Health Center, Inc Past Accepting new patients

Locations

46 Fairview Ave
Skowhegan, ME 04976
Phone (207) 858-8364

46 Fairview Ave
Ste 334
Skowhegan, ME 04976
Phone (207) 474-3320

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1150329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728000000000",
    "number": "1447294822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "180 ACADEMY ST STE 3",
            "city": "PRESQUE ISLE",
            "state": "ME",
            "postal_code": "047693183",
            "telephone_number": "207-554-2352",
            "fax_number": "207-554-2351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 MILL ST",
            "city": "HOULTON",
            "state": "ME",
            "postal_code": "047301877",
            "telephone_number": "207-532-6523",
            "fax_number": "207-532-3873"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HORN",
        "first_name": "AUDIE",
        "name_suffix": "Jr.",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-15",
        "last_updated": "2024-10-04",
        "certification_date": "2024-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ME",
            "license": "PA474",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "ME",
            "license": "PA474",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1447294822",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Houlton, ME

Sources for this page

Verify at the official NPI Registry.