SUPERIORCARE MEDICAL GROUP LLC
NPI 1124802178
Nurse Practitioner - Family in Cordova, TN
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
Specialties & Licenses 3
Secondary Practice Location 1
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Superiorcare Medical Group Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Superiorcare Medical Group LLC, which bills Medicare for the services this clinician delivers.
Clinician (1)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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.
Is Superiorcare Medical Group LLC enrolled in Medicare?
Yes. Superiorcare Medical Group LLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Superiorcare Medical Group LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Nurse Practitioner) reassigns their Medicare billing to Superiorcare Medical Group LLC. A 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 the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 22 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.
# Superiorcare Medical Group Llc · NPI 1124802178
Family organization in Cordova, Tennessee. Organization record, active in the CMS NPPES registry since August 22, 2023.
## Identity
- **NPI:** 1124802178 (Entity type: Organization)
- **Enumerated:** August 22, 2023
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **Organization subpart:** No
- **Authorized official:** Donna Luckett, MEMBER
## Practice location
- **Address:** 1175 VICKERY LN STE 101, Cordova, TN 38016-0682
- **Phone:** (662) 408-6995
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1 clinician (Nurse Practitioner) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** December 11, 2024
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Source: [NPI Profile](https://npiprofile.com/npi/1124802178) · Data from the CMS NPPES public registry.