Bradley Bibb MD PLLC

Organization Active NPI Rural Health Clinic/Center · Chickasha, OK

NPI 1013724764 · NPPES record last updated Aug 18, 2025

Key facts

NPI
1013724764
Entity type
Organization (NPI type 2)
Primary specialty
Rural Health Clinic/Center 261QR1300X
Legal business name
BRADLEY BIBB MD PLLC
Practice address
2001 S 1St St
Chickasha, OK 73018-6007
Phone
(405) 320-9444
Fax
(405) 320-9666
NPI assigned
Dec 16, 2024
Organization subpart
No

Authorized official

Name
Monya York
Title
Director Credentialing
Phone
(870) 856-1202

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Other NPIs with the same Medicare PAC ID 12

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Corporate family (same tax ID) 7

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners 129

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

View all 129

Medicare participation

Medicare fee-for-service enrollment
Enrolled in OK

Rural health clinic certification: CCN 373916

Legal name
BRADLEY BIBB MD PLLC
Doing business as
ACCES MEDICAL CLINIC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Aug 12, 2025
Last certification
Aug 12, 2025
Ownership / control type
1A
Organization structure
LLC · Proprietary
Enrollment address
2001 S 1St St
Chickasha, OK 73018-6007

All disclosed owners & managing parties 2

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Bradley Ray Bibb
Individual
5% Or Greater Direct Ownership Interest
Ceo
Jul 23, 2008 100%
Corporate Officer
Ceo
Jul 23, 2008 100%
Monya York
Individual
Corporate Director
Director Credentialing
Jul 17, 2017
W-2 Managing Employee
Director Credentialing
Jul 17, 2017

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20250605002003 OK Part a Provider - Rural Health Clinic 4789715285 Practice locations: Chickasha, OK

National Provider Directory

Tax ID family
Access Medical Clinic (8 organizations share this tax ID)

Locations

1176 State Highway 22 W
Ste B
Dardanelle, AR 72834
Phone (479) 229-3004

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician
Group: 193200000X MULTI-SPECIALTY GROUP
207Q00000X
Rural Health Clinic/Center 261QR1300X Yes

Addresses

Primary practice location

2001 S 1St St
Chickasha, OK 73018-6007

Mailing address

4196 Highway 62 412 Ste a
Hardy, AR 72542-8002
Phone (870) 856-1202

Other names

  • Access Medical Clinic Other name

Other providers in Chickasha, OK

All providers in Chickasha, OK · Rural Health Clinic/Center in Oklahoma

Sources for this page

Verify at the official NPI Registry.