CLEBURNE MEDICAL CLINIC, INC. – Clinic/Center, NPI 1104891241

CLEBURNE MEDICAL CLINIC, INC. is a healthcare provider. based in Heflin, Alabama. specializing in Clinic/Center. The NPI Number for CLEBURNE MEDICAL CLINIC, INC. is 1104891241

Main info

Organization
Name
CLEBURNE MEDICAL CLINIC, INC.
NPI
1104891241
Phone
(256) 463-7454
Address
40 GILES ST
Authorized Official
DR. IGOR BIDIKOV PRESIDENT AND OWNER M.D.
Enumeration Date
22 February 2006
Last Update Date
6 February 2008
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience45
Completeness75
Years active:20State licenses:0Digital endpointsOther names

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Provider Addresses for CLEBURNE MEDICAL CLINIC, INC.

  • Giles Street, Heflin, Cleburne County, Alabama, 36264, United States

    HEFLIN, AL 362641738

    Phone: (256) 463-7454

    Fax: (256) 463-7725

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2005-02-16

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
O20050216000813OClinic/Group PracticeALTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 36264)

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Reviews

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Frequently asked questions

How do I look up CLEBURNE MEDICAL CLINIC, INC. by NPI?
Use NPI 1104891241 when you need to reference CLEBURNE MEDICAL CLINIC, INC. in forms, claims, or directories.
Does this profile mean CLEBURNE MEDICAL CLINIC, INC. is currently active?
Yes — CLEBURNE MEDICAL CLINIC, INC. appears active in the national provider directory.
What field does CLEBURNE MEDICAL CLINIC, INC. work in?
You can think of CLEBURNE MEDICAL CLINIC, INC. as practicing within Clinic/Center. Clinical services aligned with this taxonomy classification.
Where is CLEBURNE MEDICAL CLINIC, INC.'s primary listing?
We display Heflin, Alabama because that is what the record indicates for CLEBURNE MEDICAL CLINIC, INC..
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

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