Individual provider Active NPI

Jon Douglas Cucura, R.D./CDCES

  • Registered Dietitian
  • Fort Bragg, NC
National Provider Identifier
1649478405
Registry record updated Oct 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
L002136 Issued in NC
Practice address
2817 Rock Merritt Avenue
Fort Bragg, NC 28310-2745
Phone
(910) 907-6335
Fax
(910) 907-7632
NPI assigned
Jul 3, 2007
Last updated
Oct 14, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2026

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 L002136 NC Primary

Addresses

Primary practice location

2817 Rock Merritt Avenue
Fort Bragg, NC 28310-2745

Mailing address

2817 Rock Merritt Avenue
Fort Bragg, NC 28310-0001
Phone (910) 907-6335

Other identifiers 1

IdentifierTypeStateIssuer
340084MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
L002136NCMDRegistered Dietitian

NPI Registry JSON

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

{
    "created_epoch": "1183420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1791936000000",
    "number": "1649478405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2817 ROCK MERRITT AVENUE",
            "city": "FORT BRAGG",
            "state": "NC",
            "postal_code": "283100001",
            "telephone_number": "910-907-6335",
            "fax_number": "910-907-7632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2817 ROCK MERRITT AVENUE",
            "city": "FORT BRAGG",
            "state": "NC",
            "postal_code": "283102745",
            "telephone_number": "910-907-6335",
            "fax_number": "910-907-7632"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUCURA",
        "first_name": "JON",
        "middle_name": "DOUGLAS",
        "name_prefix": "Mr.",
        "credential": "R.D./CDCES",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-03",
        "last_updated": "2026-10-14",
        "certification_date": "2026-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NC",
            "license": "L002136",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "340084",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Bragg, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2026; 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.