Individual provider Active NPI

Ajla Becirevic Gurley, RDN, LDN

  • Registered Dietitian
  • Huntersville, NC
National Provider Identifier
1376201996
Registry record updated Nov 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
L006640 Issued in NC
Practice address
16525 Holly Crest LN
Huntersville, NC 28078-4909
Phone
(704) 316-7760
Fax
(704) 316-7761
NPI assigned
Dec 1, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2024

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 L006640 NC Primary

Addresses

Primary practice location

16525 Holly Crest LN
Huntersville, NC 28078-4909

Mailing address

PO Box 60447
Charlotte, NC 28260-0447

Other practice location 1

15015 Lancaster Hwy Ste 200
Charlotte, NC 28277-2010
Phone (980) 202-7980

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241212000023 NC Practitioner - Registered Dietitian Or Nutrition Professional 2668908799 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Novant Health Medical Group, LLCGroup PAC ID 1153234893, 2,413 clinicians

Practice addresses (Care Compare)

16525 Holly Crest LN
Suite 210
Huntersville, NC 28078-4909
Phone (704) 316-7760

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
L006640NCMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Novant Health Medical Group, LLC CurrentSince Aug 16, 2024 Accepting new patients
NH-CL Clinics, LLC CurrentSince Mar 18, 2022 Accepting new patients
Novant Health Medical Group, LLC CurrentSince Aug 16, 2024 Accepting new patients
Novant Health Medical Group, LLC Current Accepting new patients
Novant Health Medical Group, LLC Past Accepting new patients

Locations

325 Hawthorne Ln
Ste 100
Charlotte, NC 28204
Phone (704) 316-7763

15015 Lancaster Hwy
Ste 200
Charlotte, NC 28277
Phone (980) 202-7980

16525 Holly Crest Ln
Ste 210
Huntersville, NC 28078
Phone (704) 799-4909

16525 Holly Crest Ln
Ste 120
Huntersville, NC 28078
Phone (704) 316-5388

5145 Sellers Rd
Shallotte, NC 28470
Phone (910) 754-4441

2825 Lyndhurst Ave
Ste 101
Winston Salem, NC 27103
Phone (336) 277-6300

Interoperability endpoints

  • Direct secure messaging: agurley1607645@direct.novanthealth.org

Organizations & group practices 18

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

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1638316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730937600000",
    "number": "1376201996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60447",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282600447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16525 HOLLY CREST LN",
            "city": "HUNTERSVILLE",
            "state": "NC",
            "postal_code": "280784909",
            "telephone_number": "704-316-7760",
            "fax_number": "704-316-7761"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15015 Lancaster Hwy Ste 200",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282772010",
            "country_code": "US",
            "telephone_number": "980-202-7980",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GURLEY",
        "first_name": "AJLA",
        "middle_name": "BECIREVIC",
        "credential": "RDN, LDN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-12-01",
        "last_updated": "2024-11-07",
        "certification_date": "2024-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NC",
            "license": "L006640",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntersville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2024; 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.