Individual provider Active NPI

Marlee Michele Wimberley, MD

  • Dermatology Physician
  • Oklahoma City, OK
National Provider Identifier
1114597291
Registry record updated May 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
43544 Issued in OK
Practice address
1000 NE 13TH St # 3960
Oklahoma City, OK 73104-5040
Phone
(405) 271-6110
NPI assigned
Jun 30, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 12, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 43544 OK Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

1000 NE 13TH St # 3960
Oklahoma City, OK 73104-5040

Mailing address

1000 NE 13TH St # 3960
Oklahoma City, OK 73104-5040
Phone (405) 271-6110

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250717003787 OK Order and Referring Only - DermatologyPractitioner - Dermatology 9436665460

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
43544OKMDDermatology Physician

NPI Registry JSON

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

{
    "created_epoch": "1625011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747008000000",
    "number": "1114597291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 NE 13TH ST # 3960",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731045040",
            "telephone_number": "405-271-6110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 NE 13TH ST # 3960",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731045040",
            "telephone_number": "405-271-6110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIMBERLEY",
        "first_name": "MARLEE",
        "middle_name": "MICHELE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-30",
        "last_updated": "2025-05-12",
        "certification_date": "2025-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "OK",
            "license": "43544",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.