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DR. KEENAN BAILEY CADDELL DO
NPI 1891596185
Student in an Organized Health Care Education/Training Program in Summerville, SC

Active since March 21, 2025PECOS Enrolled
109 BURTON AVE STE A, SUMMERVILLE, SC 29485(843) 998-1222 Get Directions Write a Review

NPPES record last updated: February 5, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Feb 5, 2026, Mar 21, 2025 (2 updates tracked since 2025).

About Dr. Keenan Bailey Caddell Do NPPES

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

DR. KEENAN BAILEY CADDELL DO (NPI 1891596185) is an individual student in an organized health care education/training program in Summerville, South Carolina and active in the NPI registry since March 2025. He is enrolled in Medicare PECOS and maintains a secondary practice location in Summerville.

NPPES Registry Identity

NPI1891596185
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameDR. KEENAN BAILEY CADDELLCredential: DO
Location Address109 BURTON AVE STE ASummerville, SC 29485-8117
Mailing Address109 Burton Ave Ste ASummerville, SC 29485-8117 · (843) 998-1222
Phone(843) 998-1222
Sole ProprietorNo
Enumeration DateMarch 21, 2025
Last NPPES UpdateFebruary 5, 20262 updates tracked since enumeration
NPPES CertifiedFebruary 5, 2026
✔ NPI 1891596185 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
109 BURTON AVE STE A, Summerville, SC 29485
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Secondary Practice Location 1

Location 1295A Midland Pkwy Ste 220Summerville, SC 29485-5902 · Phone (843) 851-3800 · Fax (843) 851-7787

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Keenan Bailey Caddell Do is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Other Providers at the Same Location NPPES 8

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

DR. DILLON MATTHEW WOODY MD
Student in an Organized Health Care Education/Training Program
109 BURTON AVE STE A
SUMMERVILLE, SC 29485
Dorchester County (205) 706-1090
CRYSTAL NATASHA BHARAT MD
Student in an Organized Health Care Education/Training Program
109 BURTON AVE STE A
SUMMERVILLE, SC 29485
Dorchester County (843) 970-5870
DR. SOPHIA ZIA MD
Student in an Organized Health Care Education/Training Program
109 BURTON AVE STE A
SUMMERVILLE, SC 29485
Dorchester County (843) 970-5870
ABD ALMASIH BARBAR ASKAR MD
Student in an Organized Health Care Education/Training Program
109 BURTON AVE STE A
SUMMERVILLE, SC 29485
Dorchester County (843) 970-5870
HEDAYA ABDELFATTAHOTHMAN MD
Student in an Organized Health Care Education/Training Program
109 BURTON AVE STE A
SUMMERVILLE, SC 29485
Dorchester County (843) 991-6981
LAILANY AGRONT DAVO MD
Student in an Organized Health Care Education/Training Program
109 BURTON AVE STE A
SUMMERVILLE, SC 29485
Dorchester County (843) 970-5810
GENEVIEVE SARAH MCCLOSKEY
Student in an Organized Health Care Education/Training Program
109 BURTON AVE STE A
SUMMERVILLE, SC 29485
Dorchester County (843) 991-6981
BRITTNEY NICOLE MOORE MD
Student in an Organized Health Care Education/Training Program
109 BURTON AVE STE A
SUMMERVILLE, SC 29485
Dorchester County (843) 998-1222

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 Keenan Caddell's NPI number?

The NPI number for Keenan Caddell is 1891596185. It was assigned to this individual provider in the NPPES registry on March 21, 2025.

Where is Keenan Caddell located?

Keenan Caddell practices at 109 Burton Ave Ste A, Summerville, SC 29485. The listed phone number is (843) 998-1222.

What is Keenan Caddell's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Keenan Caddell enrolled in Medicare?

Yes. Keenan Caddell is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Keenan Caddell was last updated on February 5, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 months 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.