Individual provider Active NPI

Donna L Burnett

  • Mental Health Counselor
  • Mason, OH
National Provider Identifier
1821078007
Registry record updated Mar 6, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
I0005449 Issued in OH
Practice address
5740 Gateway Blvd
Ste 104
Mason, OH 45040-1893
Phone
(513) 234-7870
Fax
(513) 234-7836
NPI assigned
Jan 23, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X I0005449 OH Primary

Addresses

Primary practice location

5740 Gateway Blvd
Ste 104
Mason, OH 45040-1893

Mailing address

5740 Gateway Blvd
Ste 104
Mason, OH 45040-1893
Phone (513) 234-7870

Other identifiers 1

IdentifierTypeStateIssuer
0175390MedicaidOH

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120426000041 OH Practitioner - Clinical Social Worker 7719149467 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
University of Kentucky College of Medicine, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Saba a Chughtai, LLCGroup PAC ID 9739231937, 3 clinicians

Practice addresses (Care Compare)

5740 Gateway
Mason, OH 45040-1893
Phone (513) 234-7870

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
I0005449OHMDMental Health Counselor

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1137974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488758400000",
    "number": "1821078007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5740 GATEWAY BLVD",
            "address_2": "STE 104",
            "city": "MASON",
            "state": "OH",
            "postal_code": "450401893",
            "telephone_number": "513-234-7870",
            "fax_number": "513-234-7836"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5740 GATEWAY BLVD",
            "address_2": "STE 104",
            "city": "MASON",
            "state": "OH",
            "postal_code": "450401893",
            "telephone_number": "513-234-7870",
            "fax_number": "513-234-7836"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURNETT",
        "first_name": "DONNA",
        "middle_name": "L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-23",
        "last_updated": "2017-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OH",
            "license": "I0005449",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0175390",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mason, OH

Sources for this page

Verify at the official NPI Registry.