Individual provider Active NPI

Chibuikem Samuel Dimgba, RD

  • Registered Dietitian
  • Pecos, TX
National Provider Identifier
1205533270
Registry record updated Sep 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
DT86082 Issued in TX
Practice address
2349 Medical Dr
Pecos, TX 79772-2251
Phone
(432) 447-3551
NPI assigned
Feb 10, 2023
Last updated
Sep 10, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X DT86082 TX Primary

Addresses

Primary practice location

2349 Medical Dr
Pecos, TX 79772-2251

Mailing address

2349 Medical Dr
Pecos, TX 79772-2251
Phone (432) 447-3551

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231223000154 TX Practitioner - Registered Dietitian Or Nutrition Professional 0648620104 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Reeves County Hospital DistrictGroup PAC ID 2567353469, 25 clinicians

Practice addresses (Care Compare)

2349 Medical Dr
Pecos, TX 79772-2251
Phone (432) 447-3551

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DT86082TXMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Reeves County Hospital District CurrentSince Nov 13, 2023 Accepting new patients
Reeves County Hospital District CurrentSince Nov 13, 2023 Accepting new patients

Locations

2323 Texas St
Pecos, TX 79772
Phone (432) 447-3551

2349 Medical Dr
Pecos, TX 79772
Phone (432) 447-0565

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1675987200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757462400000",
    "number": "1205533270",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2349 MEDICAL DR",
            "city": "PECOS",
            "state": "TX",
            "postal_code": "797722251",
            "telephone_number": "432-447-3551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2349 MEDICAL DR",
            "city": "PECOS",
            "state": "TX",
            "postal_code": "797722251",
            "telephone_number": "432-447-3551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIMGBA",
        "first_name": "CHIBUIKEM",
        "middle_name": "SAMUEL",
        "credential": "RD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-02-10",
        "last_updated": "2025-09-10",
        "certification_date": "2025-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "TX",
            "license": "DT86082",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pecos, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.