SUPERIORCARE MEDICAL GROUP LLC
NPI 1124802178
Nurse Practitioner - Family in Cordova, TN

Active since August 22, 2023
1175 VICKERY LN STE 101, CORDOVA, TN 38016(662) 408-6995 Get Directions Write a Review

NPPES record last updated: December 11, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Dec 11, 2024, May 7, 2024, Apr 22, 2024 and 2 more (5 updates tracked since 2023).

About Superiorcare Medical Group Llc NPPES

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

SUPERIORCARE MEDICAL GROUP LLC (NPI 1124802178) is a healthcare organization registered as a family in Cordova, Tennessee and active in the NPI registry since August 2023. The organization maintains a secondary practice location in Southaven and lists Donna Luckett, Member, as its authorized official.

NPPES Registry Identity

NPI1124802178
Entity TypeOrganization
Primary Taxonomy363LF0000X
Legal Business NameSUPERIORCARE MEDICAL GROUP LLC
Location Address1175 VICKERY LN STE 101Cordova, TN 38016-0682
Mailing Address3750 Hacks Cross Rd # 102-202Memphis, TN 38125-2367 · (662) 408-6995
Organization SubpartNo
Authorized OfficialDonna LuckettMember · (662) 403-7741
Enumeration DateAugust 22, 2023
Last NPPES UpdateDecember 11, 20245 updates tracked since enumeration
NPPES CertifiedDecember 11, 2024
NPI 1124802178 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
Also ListedFamily MedicineTaxonomy 207Q00000X
Also ListedNurse Practitioner · Primary CareTaxonomy 363LP2300X
1175 VICKERY LN STE 101, Cordova, TN 38016

Secondary Practice Location 1

Location 11223 Main St Ste BSouthaven, MS 38671-1429 · Phone (662) 408-6995

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Other Providers at the Same Location NPPES

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

Nurse Practitioner (Family)
1175 VICKERY LN STE 101
CORDOVA, TN 38016

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 Superiorcare Medical Group LLC's NPI number?

The NPI number for Superiorcare Medical Group LLC is 1124802178. It was assigned to this organization in the NPPES registry on August 22, 2023.

Where is Superiorcare Medical Group LLC located?

Superiorcare Medical Group LLC is located at 1175 Vickery Ln Ste 101, Cordova, TN 38016. The listed phone number is (662) 408-6995.

What is Superiorcare Medical Group LLC's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

When was this NPI record last updated?

The NPPES record for Superiorcare Medical Group LLC was last updated on December 11, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 20 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.