Bold Ark LLC
NPI 1740079623 · Psychiatric/Mental Health Nurse Practitioner · Loganville, GA
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Bold Ark LLC is a Psychiatric/Mental Health Nurse Practitioner organization in Loganville, GA (NPI 1740079623).
Provider details
- NPI number
- 1740079623
- Entity type
- Organization
- Primary specialty
- Psychiatric/Mental Health Nurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
- Organization subpart
- No
- Authorized official
- Olufunke Adewunmi, Ceo(678) 898-1927
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
1 yr in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2025-05-06
- Last updated
- 2026-03-27
- Certified
- 2026-03-27
Frequently asked questions
- What is Bold Ark LLC's NPI number?
- Bold Ark LLC's National Provider Identifier (NPI) is 1740079623, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Bold Ark LLC?
- Bold Ark LLC is classified in the NPPES registry as Psychiatric/Mental Health Nurse Practitioner (Physician Assistants & Advanced Practice Nursing Providers).
- Where is Bold Ark LLC located?
- Bold Ark LLC's practice location on file with NPPES is 3905 Harrison Rd Ste 500, Loganville, GA 30052-5895.
- What is Bold Ark LLC's phone number?
- The practice phone number listed in the NPPES registry for Bold Ark LLC is (678) 898-1927.
- Does Bold Ark LLC accept Medicare?
- Bold Ark LLC is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Bold Ark LLC?
- The authorized official listed on Bold Ark LLC's NPPES record is Olufunke Adewunmi, Ceo. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Bold Ark LLC's NPI active?
- Yes — Bold Ark LLC's NPI (1740079623) is active in the NPPES registry as of the last update on 2026-03-27.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.