Marvis Mimba

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

219763 Issued in OK

Practice address

4101 Perimeter Center Dr
Oklahoma City, OK 73112-2302

Phone

(563) 766-7014

NPI assigned

Aug 6, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1722902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731196800000",
    "number": "1073343828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2828 NW 57TH ST",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731126814",
            "telephone_number": "405-418-4777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4101 PERIMETER CENTER DR",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731122302",
            "telephone_number": "563-766-7014"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2828 NW 57th St",
            "address_purpose": "LOCATION",
            "city": "Oklahoma City",
            "state": "OK",
            "postal_code": "731126814",
            "country_code": "US",
            "telephone_number": "405-418-4777",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MIMBA",
        "first_name": "MARVIS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-08-06",
        "last_updated": "2024-11-10",
        "certification_date": "2024-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "OK",
            "license": "219763",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shermiah Meleah Milton-Jones, M.A.
• Camille Kathryn Milton, MD
• Dennis R Milton, BHRS
• Rosa Milton
• Tyrone Milton
• Catherine Mims
• Jeffrey L Mims Jr., B.A.
• Mark Matthew Mims, MD
• Roberta Mims, NORTHCARE CREDENTIAL
• Kyung Whan Min, MD

• General Practice Physician in Oklahoma City, OK
• Providers in Oklahoma City, OK by specialty
• General Practice Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.