Individual provider Active NPI

Erin Kukura, MS, RD, LD

  • Registered Dietitian
  • Bend, OR
National Provider Identifier
1639522436
Registry record updated Nov 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
LD-D-10224645 Issued in OR
Practice address
61133 Halley St
Bend, OR 97702
Phone
(458) 202-9495
NPI assigned
Jul 15, 2016
Last updated
Nov 8, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 8, 2023

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 LD-D-10224645 OR Primary

Addresses

Primary practice location

61133 Halley St
Bend, OR 97702

Mailing address

61133 Halley St
Bend, OR 97702-2879

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Mar 7, 2026 through Mar 7, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
LD-D-10224645ORMDRegistered Dietitian

NPI Registry JSON

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

{
    "created_epoch": "1468540800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699401600000",
    "number": "1639522436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "61133 HALLEY ST",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977022879"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "61133 HALLEY ST",
            "city": "BEND",
            "state": "OR",
            "postal_code": "97702",
            "telephone_number": "458-202-9495"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUKURA",
        "first_name": "ERIN",
        "credential": "MS, RD, LD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-07-15",
        "last_updated": "2023-11-08",
        "certification_date": "2023-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "OR",
            "license": "LD-D-10224645",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bend, OR

Sources for this page

Verify at the official NPI Registry.