Marc Luckett, M.D.

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

2002014395 Issued in MO

Practice address

12303 De Paul Dr
Bridgeton, MO 63044-2512

Phone

(314) 344-6000

NPI assigned

Feb 10, 2006

Last updated

May 1, 2026By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in MO, IA, IL, AR, MN5 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 5

Specialty

Obstetrics/Gynecology

Education

Other, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Obhg Illinois SCGroup PAC ID 7810179702, 27 clinicians

SSM Health Care St LouisGroup PAC ID 7810800737, 171 clinicians

Springfield Clinic, LLPGroup PAC ID 0547166076, 678 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations (25 of 33)

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• SSM Health Care St Louis

  dba SSM Health St Clare Fenton

  • Emergency Medicine Physician
  • Fenton, MO
  • NPI 1275586174
  Medicare reassignment Care Compare group NPD
• Obhg Illinois SC

  • Obstetrics & Gynecology Physician
  • Berwyn, IL
  • NPI 1700107216
  Medicare reassignment Care Compare group NPD
• Springfield Clinic, LLP

  • Multi-Specialty Clinic/Center
  • Springfield, IL
  • NPI 1780638478

  Obstetrics & Gynecology

  Medicare reassignment Care Compare group NPD
• Carestl Health

  dba Homer G. Phillips Health Center

  • Federally Qualified Health Center (FQHC)
  • Saint Louis, MO
  • NPI 1376685529
  Medicare reassignment NPD
• Mercy Clinic Springfield Communities

  • Family Medicine Physician
  • Springfield, MO
  • NPI 1245277631
  Medicare reassignment NPD
• Mercy Clinic Springfield Communities

  dba Mercy Clinic Family Medicine-Willow Springs

  • Rural Health Clinic/Center
  • Willow Springs, MO
  • NPI 1972771657
  Medicare reassignment NPD
• Saint Lukes Hospital of Chillicothe

  dba Hedrick Medical Center

  • Emergency Medicine Physician
  • Chillicothe, MO
  • NPI 1245433127

  Obstetrics & Gynecology

  Medicare reassignment NPD
• Southeast Missouri Hospital Physicians, LLC

  dba Mercy Clinic Southeast

  • Family Medicine Physician
  • Cape Girardeau, MO
  • NPI 1558311522

  Obstetrics & Gynecology

  Medicare reassignment NPD
• Broadlawns Medical Center

  • General Acute Care Hospital
  • Des Moines, IA
  • NPI 1467447508
  Medicare reassignment NPD
• Heartland Women's Healthcare LTD

  • Obstetrics & Gynecology Physician
  • Marion, IL
  • NPI 1851307532
  Medicare reassignment NPD
• Mercy Clinic Fort Smith Communities

  • Multi-Specialty Clinic/Center
  • Fort Smith, AR
  • NPI 1902073620
  Medicare reassignment NPD
• Mercy Specialty Clinic

  dba MercyOne Specialty Care

  • Multi-Specialty Clinic/Center
  • Clinton, IA
  • NPI 1386832764
  Medicare reassignment NPD

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

{
    "created_epoch": "1139529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777593600000",
    "number": "1881667608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12303 DE PAUL DR",
            "city": "BRIDGETON",
            "state": "MO",
            "postal_code": "630442512",
            "fax_number": "913-651-1041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12303 DE PAUL DR",
            "city": "BRIDGETON",
            "state": "MO",
            "postal_code": "630442512",
            "telephone_number": "314-344-6000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1001 6th Ave",
            "address_2": "Suite 230",
            "address_purpose": "LOCATION",
            "city": "Leavenworth",
            "state": "KS",
            "postal_code": "660483222",
            "country_code": "US",
            "telephone_number": "913-651-2163",
            "fax_number": "913-651-1041",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "701 N 1st St",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "IL",
            "postal_code": "627810001",
            "country_code": "US",
            "telephone_number": "217-528-7541",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LUCKETT",
        "first_name": "MARC",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-10",
        "last_updated": "2026-05-01",
        "certification_date": "2026-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MO",
            "license": "2002014395",
            "primary": true
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "KS",
            "license": "04-34430",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "IL",
            "license": "036154158",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Loving Sister's Home Care LLC
• Skylah Faith Lozano, DPM
• James J Lu, MD
• Xinrong Lu, M.D.
• Kayla Lucas, LMSW
• Casie Ludwig
• Kelty Lufcy, M.A.
• Jonathan Jerome Lusardi, M.D.
• Kimberly L. Luu, PA
• Luxottica of America Inc (Target Optical F578)

• Obstetrics & Gynecology Physician in Bridgeton, MO
• Providers in Bridgeton, MO by specialty
• Obstetrics & Gynecology Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.