Cleburne Medical Clinic, Inc.

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

CLEBURNE MEDICAL CLINIC, INC.

Practice address

40 Giles St
Heflin, AL 36264-1738

Phone

(256) 463-7454

Fax

(256) 463-7725

NPI assigned

Feb 22, 2006

Last updated

Feb 6, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Igor Bidikov, M.D.NPI 1649247545

Title

President and Owner

Phone

(256) 463-7454

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in AL

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Tax ID family

Anniston Geriatrics2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Cleburne Medical Clinic

  dba Anniston Geriatrics

  • Primary Care Clinic/Center
  • Anniston, AL
  • NPI 1457429516
  NPD tax ID

Locations

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Igor Bidikov, MD

  • Geriatric Medicine (Internal Medicine) Physician
  • Heflin, AL
  • NPI 1649247545
  Medicare reassignment Care Compare group NPD Authorized official
• Muzamil E. Babiker, MD

  • Internal Medicine Physician
  • Anniston, AL
  • NPI 1609897503
  Medicare reassignment Care Compare group NPD
• Raul Magadia, MD

  • Infectious Disease Physician
  • Anniston, AL
  • NPI 1326015231
  Medicare reassignment Care Compare group NPD
• Louis Divalentin, M.D.

  • Internal Medicine Physician
  • Anniston, AL
  • NPI 1982625869
  Medicare reassignment NPD
• Almena Free, M.D.

  • Internal Medicine Physician
  • Anniston, AL
  • NPI 1144244070
  Medicare reassignment NPD
• Tatiana Bidikov, MD

  • Pediatrics Physician
  • Anniston, AL
  • NPI 1902873821
  NPD (past)

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

{
    "created_epoch": "1140566400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1202256000000",
    "number": "1104891241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 GILES ST",
            "city": "HEFLIN",
            "state": "AL",
            "postal_code": "362641738",
            "telephone_number": "256-463-7454",
            "fax_number": "256-463-7725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 GILES ST",
            "city": "HEFLIN",
            "state": "AL",
            "postal_code": "362641738",
            "telephone_number": "256-463-7454",
            "fax_number": "256-463-7725"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLEBURNE MEDICAL CLINIC, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-22",
        "last_updated": "2008-02-06",
        "status": "A",
        "authorized_official_last_name": "BIDIKOV",
        "authorized_official_first_name": "IGOR",
        "authorized_official_title_or_position": "PRESIDENT AND OWNER",
        "authorized_official_telephone_number": "256-463-7454",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD GROUP NUMBER",
            "identifier": "DB4844",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE PROV ID",
            "identifier": "P00108638",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cleburne County Health Dept Pri Care
• Cleburne County Health Dept STD
• Cleburne County Health Dept VFC Immun
• Cleburne County Hospital Board Inc (Cleburne County EMS)
• Cleburne County Hospital Board, Inc. (Cleburne County Nursing Home)
• Cleburne Pharmacy LLC
• Cleburne Pharmacy LLC (Cleburne Pharmacy)
• Ryan Crosby
• Paul Del Giudice, LICSW
• Durable Medical Equipment, Inc (Bowdon Homecare)

• Clinic/Center in Heflin, AL
• Providers in Heflin, AL by specialty
• Clinic/Center in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.