NPIMap

Organization Active NPI

Bradley Bibb MD PLLC

Doing business as access medical clinic

  • Rural Health Clinic/Center
  • Marked Tree, AR
National Provider Identifier
1831595057
Registry record updated Jan 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
BRADLEY BIBB MD PLLC
Doing business as
access medical clinic
Practice address
202 Newsome Dr
Marked Tree, AR 72365-2021
Phone
(870) 358-4355
Fax
(870) 994-7488
NPI assigned
Nov 16, 2014
Last updated
Jan 28, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2026

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

Authorized official

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

Specialties & licenses 2

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

Addresses

Primary practice location

202 Newsome Dr
Marked Tree, AR 72365-2021

Mailing address

4196 Highway 62 412 Ste a
Hardy, AR 72542-8002

Other names 1

  • access medical clinic Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20100628000488 AR Part B Supplier - Clinic/Group Practice 4789715285 Receives reassigned benefits from 95 practitioners
11 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Ash Flat, AR; Black Rock, AR; Bono, AR; Dardanelle, AR; Hardy, AR; Marked Tree, AR; Salem, AR; Texarkana, AR
O20141208001330 AR Part A Provider - Rural Health Clinic 4789715285 Practice locations: Marked Tree, AR

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1831595057. Details of each certification follow.

Rural health clinic certification: CCN 043879

Legal name
BRADLEY BIBB MD PLLC
Doing business as
ACCESS MEDICAL CLINIC MARKED TREE
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Mar 13, 2015
Last certification
Jan 22, 2020
Ownership / control type
1A
Organization structure
LLCProprietary
Incorporated
Jul 23, 2008 in AR
Enrollment address
202 Newsome Drive
Marked Tree, AR 72365-2021

Other NPIs with the same Medicare PAC ID 12

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

Other NPIs on the same Medicare enrollment 10

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Access Medical Clinic8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

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

Locations

49 Highway 62 412
Ste 412
Ash Flat, AR 72513

Ownership & related parties

All disclosed owners & managing parties 6

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

NameRoleSinceShare
Mark Hahn Individual 5% Or Greater Direct Ownership Interest May 8, 2025 100%
Corporate OfficerMedical Director May 8, 2025
Jared Clifford Individual Corporate OfficerPresident May 8, 2025
Sheri N Davis Individual W-2 Managing EmployeeVP of Provider Mgmnt May 8, 2025
Monya York Individual Corporate DirectorDirector Credentialing May 8, 2025
W-2 Managing EmployeeDirector Credentialing May 8, 2025
Randi L Davis Individual W-2 Managing EmployeeDirector of Provider Mgmnt May 8, 2025
Candice M Cartwright Individual W-2 Managing EmployeeClinic Director May 8, 2025

Owners & managing parties with NPI records 4

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

Practitioners & affiliated clinicians

Practitioners 40

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.

View all 40

NPI Registry JSON

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

{
    "created_epoch": "1416096000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1769558400000",
    "number": "1831595057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4196 HIGHWAY 62 412 STE A",
            "city": "HARDY",
            "state": "AR",
            "postal_code": "725428002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 NEWSOME DR",
            "city": "MARKED TREE",
            "state": "AR",
            "postal_code": "723652021",
            "telephone_number": "870-358-4355",
            "fax_number": "870-994-7488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRADLEY BIBB MD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-11-16",
        "last_updated": "2026-01-28",
        "certification_date": "2026-01-28",
        "status": "A",
        "authorized_official_last_name": "YORK",
        "authorized_official_first_name": "MONYA",
        "authorized_official_title_or_position": "DIRECTOR CREDENTIALING",
        "authorized_official_telephone_number": "870-856-1202"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "access medical clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "access medical clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Marked Tree, AR

Sources for this page

Verify at the official NPI Registry.