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DONNA MARIE BURKHOLDER
NPI 1205317740
Counselor in Moraine, OH

Active since August 23, 2018PECOS EnrolledAccepts Medicare Assignment
3095 KETTERING BLVD, MORAINE, OH 45439(937) 293-8300 Get Directions Write a Review

NPPES record last updated: November 6, 2019. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Nov 6, 2019, Aug 23, 2018 (2 updates tracked since 2018).

About Donna Marie Burkholder NPPES

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

DONNA MARIE BURKHOLDER (NPI 1205317740) is an individual counselor in Moraine, Ohio and active in the NPI registry since August 2018. She is enrolled in Medicare PECOS and is a graduate of Other (2020).

NPPES Registry Identity

NPI1205317740
Entity TypeIndividualFemale
Primary Taxonomy101Y00000X
Provider Legal NameDONNA MARIE BURKHOLDER
Location Address3095 KETTERING BLVDMoraine, OH 45439-1983
Mailing Address8014 Washington Park DrDayton, OH 45459-3653 · (937) 216-2899
Phone(937) 293-8300
Sole ProprietorNo
Medical School CMSOtherGraduated 2020
Enumeration DateAugust 23, 2018
Last NPPES UpdateNovember 6, 20192 updates tracked since enumeration
✔ NPI 1205317740 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselorBehavioral Health & Social Service Providers
Taxonomy Code101Y00000X
Definition
A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification.
3095 KETTERING BLVD, Moraine, OH 45439
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Other Names 1

Former Name (1)Donna Marie Graham

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Donna Marie Burkholder is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID2668906587
PECOS Enrollment IDI20241114000312
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Donna Burkholder reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

South Community Inc
Same address
Mental Health (Including Community Mental Health Center)
3095 KETTERING BLVD
Moraine, OH 45439
  • Reassigned Medicare billing, Ohio enrollment
  • 50 clinicians in this Medicare group
NPI 1639128176 (937) 293-8300

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 20

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

ELISSA NICHOLE HOSTETTER
Social Worker
3095 KETTERING BLVD
MORAINE, OH 45439
Montgomery County (937) 534-1384
HOLLY MICHELLE VADNAIS
Case Manager/Care Coordinator
3095 KETTERING BLVD
MORAINE, OH 45439
Montgomery County (937) 293-8300
ELIZABETH LIAPIS LISW-SUPV
Social Worker (Clinical)
3095 KETTERING BLVD
MORAINE, OH 45439
Montgomery County (937) 293-8300
KIMBERLY YATES
Case Manager/Care Coordinator
3095 KETTERING BLVD
MORAINE, OH 45439
Montgomery County (937) 293-8300
LOGAN BRUNO
Case Manager/Care Coordinator
3095 KETTERING BLVD
MORAINE, OH 45439
Montgomery County (937) 293-8300
MISS WILLIETTE ANDERSON
Case Manager/Care Coordinator
3095 KETTERING BLVD
MORAINE, OH 45439
Montgomery County (937) 991-4817
HANNAH MILLER
Case Manager/Care Coordinator
3095 KETTERING BLVD
MORAINE, OH 45439
Montgomery County (937) 534-1554
MORGAN RENCH
Case Manager/Care Coordinator
3095 KETTERING BLVD
MORAINE, OH 45439
Montgomery County (937) 293-8300

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 Donna Burkholder's NPI number?

The NPI number for Donna Burkholder is 1205317740. It was assigned to this individual provider in the NPPES registry on August 23, 2018. The provider is also known as Donna Marie Graham.

Where is Donna Burkholder located?

Donna Burkholder practices at 3095 Kettering Blvd, Moraine, OH 45439. The listed phone number is (937) 293-8300.

What is Donna Burkholder's specialty?

The primary specialty registered for this NPI is Counselor with taxonomy code 101Y00000X.

Is Donna Burkholder enrolled in Medicare?

Yes. Donna Burkholder is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organization bills Medicare for Donna Burkholder's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Donna Burkholder reassigns Medicare benefits to South Community Inc (Moraine, OH). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Donna Burkholder's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Donna Burkholder was last updated on November 6, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years 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.