Superiorcare Medical Group LLC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

Legal business name

SUPERIORCARE MEDICAL GROUP LLC

Practice address

1175 Vickery LN Ste 101
Cordova, TN 38016-0682

Phone

(662) 408-6995

NPI assigned

Aug 22, 2023

Organization subpart

No

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

Authorized official

Name

Donna Luckett, FNPNPI 1609332840

Title

Member

Phone

(662) 403-7741

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in TN, MS2 enrollments

Enrollment records 2

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Donna Luckett, FNP

  • Family Nurse Practitioner
  • Cordova, TN
  • NPI 1609332840

  MS

  Medicare reassignment Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1692662400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733875200000",
    "number": "1124802178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3750 HACKS CROSS RD # 102-202",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381252367",
            "telephone_number": "662-408-6995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1175 VICKERY LN STE 101",
            "city": "CORDOVA",
            "state": "TN",
            "postal_code": "380160682",
            "telephone_number": "662-408-6995"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1223 Main St Ste B",
            "address_purpose": "LOCATION",
            "city": "Southaven",
            "state": "MS",
            "postal_code": "386711429",
            "country_code": "US",
            "telephone_number": "662-408-6995",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SUPERIORCARE MEDICAL GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-08-22",
        "last_updated": "2024-12-11",
        "certification_date": "2024-12-11",
        "status": "A",
        "authorized_official_last_name": "LUCKETT",
        "authorized_official_first_name": "DONNA",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "662-403-7741",
        "authorized_official_credential": "FNP"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Leslie Alison Stucker, NP
• Jeffrey Lee Summers, O.D.
• Mary Grace Summers, O.D.
• Melvin Summerville Sr.
• Zhiqiang Sun, MD
• Lindsey Swafford, M.S., BCBA, LBA
• Latoya Charmaine Swagerty, LMSW
• Usha B Swamy, M.D.
• Dodgen Nathaniel Swanson, DC
• Richard Dean Sykes, APRN, BC

• Family Nurse Practitioner in Cordova, TN
• Providers in Cordova, TN by specialty
• Family Nurse Practitioner in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.