Bradley Bibb MD PLLC

Organization Active NPI Rural Health Clinic/Center · Frankfort, IN

NPI 1831906593 · NPPES record last updated Feb 12, 2026

Key facts

NPI
1831906593
Entity type
Organization (NPI type 2)
Primary specialty
Rural Health Clinic/Center 261QR1300X
Legal business name
BRADLEY BIBB MD PLLC
Practice address
2460 E Wabash St
Frankfort, IN 46041-9429
Phone
(765) 357-3800
Fax
(765) 357-3813
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 4

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

Other NPIs on the same Medicare enrollment 1

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

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 72

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

View all 72

Laboratory certificates & supplier records

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
15D2317395Bradley Bibb MD PLLC
2460 E Wabash St, AMC, Frankfort, IN 46041
Certificate of waiverJan 22, 2027

Medicare participation

Medicare fee-for-service enrollment
Enrolled (2 enrollments) in IN

Rural health clinic certification: CCN 153961

Legal name
BRADLEY BIBB MD PLLC
Doing business as
ACCESS MEDICAL CLINIC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Aug 26, 2025
Last certification
Aug 26, 2025
Ownership / control type
1A
Organization structure
LLC · Proprietary
Enrollment address
2460 E Wabash St
Frankfort, IN 46041-9429

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
DO
May 8, 2025 100%
Corporate Officer
Medical Director
May 8, 2025
W-2 Managing Employee
MD;
May 8, 2025
Jared Clifford
Individual
Corporate Officer
President
May 8, 2025
Sheri N Davis
Individual
W-2 Managing Employee
VP of Provider Mgmnt
May 8, 2025
Monya York
Individual
Corporate Director
Director Credentialing
Jul 17, 2017
W-2 Managing Employee
Director Credentialing
Jul 17, 2017
Operational/Managerial Control
Director Credentialing
Jul 17, 2017
Randi L Davis
Individual
W-2 Managing Employee
Director of Provider Mgmnt
May 8, 2025
Candice M Cartwright
Individual
W-2 Managing Employee
Clinic Director
May 8, 2025

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20250404001511 IN Part B Supplier - Clinic/Group Practice 4789715285 Receives reassigned benefits from 9 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Frankfort, IN; Huntington, IN
O20250527000087 IN Part a Provider - Rural Health Clinic 4789715285 Practice locations: Frankfort, IN

National Provider Directory

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

Specialties & licenses

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

Addresses

Primary practice location

2460 E Wabash St
Frankfort, IN 46041-9429

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 Frankfort, IN

All providers in Frankfort, IN · Rural Health Clinic/Center in Indiana

Sources for this page

Verify at the official NPI Registry.