Individual provider Active NPI

Douglas Eli Cunningham, DPM

  • Podiatrist
  • Cheraw, SC
National Provider Identifier
1699761874
Registry record updated Aug 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
522 Issued in SC
Practice address
812 State Rd
Cheraw, SC 29520-2130
Phone
(843) 537-0961
Fax
(843) 537-0908
NPI assigned
Sep 23, 2005
Last updated
Aug 20, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 522 SC Primary
Foot Surgery Podiatrist 213ES0131X 522 SC

Addresses

Primary practice location

812 State Rd
Cheraw, SC 29520-2130

Mailing address

PO Box 1090
Hartsville, SC 29551-1090
Phone (843) 857-0111

Other identifiers 1

IdentifierTypeStateIssuer
PD5220MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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
I20100628000354 SC Practitioner - Podiatry 5799816286 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Kent State University College of Podiatric Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Caresouth Carolina Inc.Group PAC ID 1052221314, 66 clinicians

Practice addresses (Care Compare)

545 Sumter Hwy
Bishopville, SC 29010-7601
Phone (803) 484-5317

715 S Doctors Dr
Suites a B and D/E
Cheraw, SC 29520-7113
Phone (843) 537-0961

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
522SCMDFoot Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Caresouth Carolina, Inc CurrentSince Jan 8, 2024 Accepting new patients
Caresouth Carolina, Inc. Current Accepting new patients
Lawrence J. Kales DPM Podiatrist Past Accepting new patients
Lawrence J Kales D P M P a Podiatrist Past Accepting new patients
Caresouth Carolina, Inc Past Accepting new patients
Larry J. Kipp DPM PA Podiatrist Past Accepting new patients

Locations

1268 S 4th St
Hartsville, SC 29550
Phone (843) 332-3422

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, 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": "1127433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755648000000",
    "number": "1699761874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1090",
            "city": "HARTSVILLE",
            "state": "SC",
            "postal_code": "295511090",
            "telephone_number": "843-857-0111",
            "fax_number": "843-309-8126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "812 STATE RD",
            "city": "CHERAW",
            "state": "SC",
            "postal_code": "295202130",
            "telephone_number": "843-537-0961",
            "fax_number": "843-537-0908"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUNNINGHAM",
        "first_name": "DOUGLAS",
        "middle_name": "ELI",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-23",
        "last_updated": "2025-08-20",
        "certification_date": "2025-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "SC",
            "license": "522",
            "primary": true
        },
        {
            "code": "213ES0131X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot Surgery",
            "state": "SC",
            "license": "522",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PD5220",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cheraw, SC

Sources for this page

Verify at the official NPI Registry.