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LIFECORE HEALTH GROUP
NPI 1679903546
Clinic/Center - Rural Health in Tupelo, MS

Active since November 13, 2013CLIA Certified · 2 labs
499 GLOSTER CREEK VLG, SUITE A-3, TUPELO, MS 38801(662) 844-1717(662) 680-6416 Get Directions Write a Review

NPPES record last updated: February 27, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Lifecore Health Group NPPES

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

LIFECORE HEALTH GROUP (NPI 1679903546) is a healthcare organization registered as a rural health in Tupelo, Mississippi and active in the NPI registry since November 2013. The organization holds 2 active CLIA laboratory certificates and lists Rita Berthay, Ceo, as its authorized official.

NPPES Registry Identity

NPI1679903546
Entity TypeOrganization
Primary Taxonomy261QR1300X
Legal Business NameNORTHEAST MENTAL HEALTH-MENTAL RETARDATION COMMISSION
Location Address499 GLOSTER CREEK VLG, SUITE A-3Tupelo, MS 38801-4600
Mailing Address2434 S Eason BlvdTupelo, MS 38804-6942 · (662) 640-4595 · Fax (662) 680-6416
Phone(662) 844-1717
Fax(662) 680-6416
Organization SubpartNo
Authorized OfficialRita BerthayCeo · (662) 640-4595
Enumeration DateNovember 13, 2013
Last NPPES UpdateFebruary 27, 2020
✔ NPI 1679903546 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyClinic/Center · Rural HealthAmbulatory Health Care Facilities
Taxonomy Code261QR1300X
Also ListedClinic/Center · Multi-SpecialtyTaxonomy 261QM1300X
499 GLOSTER CREEK VLG, Tupelo, MS 38801
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Other Names 1

Doing Business AsLifecore Health Group

Other Identifiers 3

Medicaid000MS
Other0000MS · Blue Cross
Medicaid0000000MS

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter from Magnolia Health and more.Insurance ›

CLIA Laboratory Certificates CMS CLIA 2

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 25D2003856

Lifecore Health Group · Tupelo, MS
Active · expires Feb 18, 2028
CLIA Number25D2003856
Laboratory TypeCommunity Mental Health
Certificate Effective DateFebruary 19, 2026
Certificate Expiration DateFebruary 18, 2028
Laboratory DirectorRicardo J. Fraga
Laboratory Phone(662) 640-4595
Laboratory LocationLifecore Health Group2434 South Eason Blvd, Tupelo, MS 38804
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 25D2070628

Lifecore Health Group · Tupelo, MS
Active · expires Dec 19, 2027
CLIA Number25D2070628
Laboratory TypeRural Health Clinic
Certificate Effective DateDecember 20, 2025
Certificate Expiration DateDecember 19, 2027
Laboratory DirectorRicardo Fraga
Laboratory Phone(662) 640-4595
Laboratory LocationLifecore Health Group499 Gloster Creek Village Suite A-3, Tupelo, MS 38801
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 20

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

DR. JON T POSEY MD
Urology
499 GLOSTER CREEK VLG, SUITE A1
TUPELO, MS 38801
Lee County (662) 377-7100
MILAN EDWARD IVANCIC MD
Pediatrics
499 GLOSTER CREEK VLG, SUITE H-3
TUPELO, MS 38801
Lee County (662) 840-6026
JANA LOUANN PETERSON NP
Nurse Practitioner (Family)
499 GLOSTER CREEK VLG, STE A2
TUPELO, MS 38801
Lee County (662) 620-6800
JENNIFER G. ESTOCK WHNP-BC, ANP-C
Nurse Practitioner
499 GLOSTER CREEK VLG, SUITE D-1
TUPELO, MS 38801
Lee County (662) 690-8007
JORDAN WARD LPN
Licensed Practical Nurse
499 GLOSTER CREEK VLG
TUPELO, MS 38801
Lee County (662) 844-1717
MR. MICHAEL H PETTIS LCSW
Social Worker (Clinical)
499 GLOSTER CREEK VLG, SUITE D-1
TUPELO, MS 38801
Lee County (662) 842-4651
MS. KATHERINE MCDUFFIE FNP
Nurse Practitioner
499 GLOSTER CREEK VLG, SUITE A-2
TUPELO, MS 38801
Lee County (662) 620-6800
ACCESS FAMILY HEALTH SERVICES, INC.
Clinic/Center (Federally Qualified Health Center (FQHC))
499 GLOSTER CREEK VLG, SUITE D-1
TUPELO, MS 38801
Lee County (662) 690-8007

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 Northeast Mental Health-Mental Retardation Commission's NPI number?

The NPI number for Northeast Mental Health-Mental Retardation Commission is 1679903546. It was assigned to this organization in the NPPES registry on November 13, 2013. The provider is doing business as Lifecore Health Group.

Where is Northeast Mental Health-Mental Retardation Commission located?

Northeast Mental Health-Mental Retardation Commission is located at 499 Gloster Creek Vlg Suite A-3, Tupelo, MS 38801. The listed phone number is (662) 844-1717.

What is Northeast Mental Health-Mental Retardation Commission's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Rural Health, with taxonomy code 261QR1300X.

Does Northeast Mental Health-Mental Retardation Commission hold CLIA laboratory certificates?

Yes. 2 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

What insurance does Northeast Mental Health-Mental Retardation Commission accept?

Health plans from Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter from Magnolia Health, Ambetter of Alabama and Ambetter of Tennessee and 2 other insurers list Northeast Mental Health-Mental Retardation Commission as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Northeast Mental Health-Mental Retardation Commission was last updated on February 27, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years 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.