Individual provider Active NPI

Peter Cunningham, D.P.M

  • Podiatrist
  • Louisville, KY
National Provider Identifier
1578112983
Registry record updated Oct 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
016005968 Issued in IL
Practice address
1 Audubon Plaza Dr Ofc L2
Louisville, KY 40217-1318
Phone
(502) 636-7111
NPI assigned
Sep 9, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 016005968 IL Primary
Foot & Ankle Surgery Podiatrist 213ES0103X 016005968 IL
Podiatrist 213E00000X 246958 KY

Addresses

Primary practice location

1 Audubon Plaza Dr Ofc L2
Louisville, KY 40217-1318

Mailing address

5401 N Knoxville Ave Ste 308
Peoria, IL 61614-5099
Phone (309) 691-6610

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220718001701 IL Practitioner - Podiatry 6608257969 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Des Moines University of Osteopathic Medicine and Health Sciences, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carle Health Care IncorporatedGroup PAC ID 3577515774, 1,592 clinicians
Proctor Health SystemsGroup PAC ID 3476440173, 131 clinicians

Practice addresses (Care Compare)

201 N Cummings LN
Washington, IL 61571-2181
Phone (309) 444-3627

205 N Cummings LN
Suite B
Washington, IL 61571-2181
Phone (309) 691-6610

209 N Cummings LN
Washington, IL 61571-2181
Phone (309) 643-6185

221 NE Glen Oak Ave
Peoria, IL 61636-0001

3591 Griffin Ave
Pekin, IL 61554-6258

5401 N Knoxville Ave
Suite 308
Peoria, IL 61614-5099
Phone (309) 691-6610

5401 N Knoxville Ave
Suite 418
Peoria, IL 61614-5073
Phone (309) 672-4670

5409 N Knoxville Ave
Peoria, IL 61614-5069
Phone (309) 691-1000

611 W Park St
Urbana, IL 61801-2501
Phone (888) 712-2753

815 Main St
Peoria, IL 61602-1076
Phone (309) 672-4977

815 Main St
Suite a
Peoria, IL 61602-1080
Phone (309) 672-4977

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of tissue74
Removal of nail tissue148
Removal or shaving of skin growth25

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
246958KYMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Proctor Health Systems CurrentSince Jul 25, 2022 Accepting new patients
Methodist Medical Center of Illinois CurrentSince Mar 19, 2025 Accepting new patients
Carle Health Care Incorporated CurrentSince Jan 1, 2026 Accepting new patients
Proctor Health Systems CurrentSince Jul 25, 2022 Accepting new patients
Methodist Medical Center of Illinois CurrentSince Mar 19, 2025 Accepting new patients
Gibson Community Hospital Association Past Accepting new patients

Locations

1776 Westlakes Pkwy
Ste 400
West Des Moines, IA 50266
Phone (515) 241-6161

221 NE Glen Oak Ave
Peoria, IL 61636
Phone (309) 672-4281

815 Main St
Ste A
Peoria, IL 61602
Phone (309) 672-4986

815 Main St
Ste A1
Peoria, IL 61602

5401 N Knoxville Ave
Ste 418
Peoria, IL 61614
Phone (309) 671-8231

5401 N Knoxville Ave
Ste 308
Peoria, IL 61614
Phone (309) 691-6610

5401 N Knoxville Ave
Ste 400
Peoria, IL 61614
Phone (309) 691-6610

611 W Park St
Urbana, IL 61801
Phone (217) 383-6941

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 and National Provider Directory roles.

Hospital & facility affiliations 3

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": "1567987200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728604800000",
    "number": "1578112983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5401 N KNOXVILLE AVE STE 308",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616145099",
            "telephone_number": "309-691-6610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 AUDUBON PLAZA DR OFC L2",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402171318",
            "telephone_number": "502-636-7111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUNNINGHAM",
        "first_name": "PETER",
        "credential": "D.P.M",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-09-09",
        "last_updated": "2024-10-11",
        "certification_date": "2024-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "IL",
            "license": "016005968",
            "primary": true
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "IL",
            "license": "016005968",
            "primary": false
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "KY",
            "license": "246958",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.