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MARVIS MIMBA
NPI 1073343828
General Practice in Oklahoma City, OK

Active since August 06, 2024
4101 PERIMETER CENTER DR, OKLAHOMA CITY, OK 73112(563) 766-7014 Get Directions Write a Review

NPPES record last updated: November 10, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Nov 10, 2024, Aug 6, 2024 (2 updates tracked since 2024).

About Marvis Mimba NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MARVIS MIMBA (NPI 1073343828) is an individual general practice provider in Oklahoma City, Oklahoma, licensed in Oklahoma (219763) and active in the NPI registry since August 2024. She maintains a secondary practice location in Oklahoma City.

NPPES Registry Identity

NPI1073343828
Entity TypeIndividualFemale
Primary Taxonomy208D00000X
Provider Legal NameMARVIS MIMBA
Location Address4101 PERIMETER CENTER DROklahoma City, OK 73112-2302
Mailing Address2828 Nw 57th StOklahoma City, OK 73112-6814 · (405) 418-4777
Phone(563) 766-7014
Sole ProprietorNo
Enumeration DateAugust 6, 2024
Last NPPES UpdateNovember 10, 20242 updates tracked since enumeration
NPPES CertifiedNovember 10, 2024
✔ NPI 1073343828 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyGeneral PracticeAllopathic & Osteopathic Physicians
Taxonomy Code208D00000X
License✔ Licensed in OK · 219763
Definition
A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee
4101 PERIMETER CENTER DR, Oklahoma City, OK 73112
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Secondary Practice Location 1

Location 12828 NW 57th StOklahoma City, OK 73112-6814 · Phone (405) 418-4777

Other Providers at the Same Location NPPES 11

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CAROLE TAYO
Nurse Practitioner
4101 PERIMETER CENTER DR
OKLAHOMA CITY, OK 73112
Oklahoma County (405) 226-0843
CHOICES FOR LIFE FOSTER CARE INC.
Foster Care Agency
4101 PERIMETER CENTER DR, SUITE 250
OKLAHOMA CITY, OK 73112
Oklahoma County (405) 751-0800
CHRISTINA PHILIP
Nurse Practitioner (Family)
4101 PERIMETER CENTER DR
OKLAHOMA CITY, OK 73112
Oklahoma County (405) 702-7750
KRISTI LYNN SELENSKY LPC
Counselor (Mental Health)
4101 PERIMETER CENTER DR, STE. 250
OKLAHOMA CITY, OK 73112
Oklahoma County (405) 751-0800
MELISSA EVANS LMSW US LCSW
Social Worker (Clinical)
4101 PERIMETER CENTER DR, STE #250
OKLAHOMA CITY, OK 73112
Oklahoma County (405) 751-0800
ERIN WIX APRN-FNP-C
Nurse Practitioner (Family)
4101 PERIMETER CENTER DR
OKLAHOMA CITY, OK 73112
Oklahoma County (888) 852-1988
CHRISTINA LAN CAOILE WARDHANA FNP-BC
Nurse Practitioner
4101 PERIMETER CENTER DR
OKLAHOMA CITY, OK 73112
Oklahoma County (608) 783-7532
MRS. MARY ELIZABETH JACKSON
Counselor
4101 PERIMETER CENTER DR, SUITE 250
OKLAHOMA CITY, OK 73112
Oklahoma County (405) 751-0800

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Marvis Mimba's NPI number?

The NPI number for Marvis Mimba is 1073343828. It was assigned to this individual provider in the NPPES registry on August 6, 2024.

Where is Marvis Mimba located?

Marvis Mimba practices at 4101 Perimeter Center Dr, Oklahoma City, OK 73112. The listed phone number is (563) 766-7014.

What is Marvis Mimba's specialty?

The primary specialty registered for this NPI is General Practice with taxonomy code 208D00000X.

When was this NPI record last updated?

The NPPES record for Marvis Mimba was last updated on November 10, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 21 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.