Bold Legacy Practice, LLC
NPI 1972212116 · Urgent Care Clinic/Center · Marietta, GA
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Bold Legacy Practice, LLC is a Urgent Care Clinic/Center organization in Marietta, GA (NPI 1972212116).
Provider details
- NPI number
- 1972212116
- Entity type
- Organization
- Primary specialty
- Urgent Care Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Leia Dawson, Medical Director(205) 907-5342
Specialties & taxonomies
Ambulatory Health Care Facilities
- Clinic/Center261Q00000X
Ambulatory Health Care Facilities
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
3 yrs 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
Other names (DBA / former)
- Doing business as
- American Family Care
- Doing business as
- Bold Legacy Management, LLC
- Doing business as
- Quadrivium Health LLC
- Doing business as
- Quadrivium Health LLC
Registry dates
- Enumerated
- 2022-11-16
- Last updated
- 2024-01-05
- Certified
- 2024-01-05
Frequently asked questions
- What is Bold Legacy Practice, LLC's NPI number?
- Bold Legacy Practice, LLC's National Provider Identifier (NPI) is 1972212116, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Bold Legacy Practice, LLC?
- Bold Legacy Practice, LLC is classified in the NPPES registry as Urgent Care Clinic/Center (Ambulatory Health Care Facilities).
- Where is Bold Legacy Practice, LLC located?
- Bold Legacy Practice, LLC's practice location on file with NPPES is 1401 Johnson Ferry Rd Ste 390, Marietta, GA 30062-9100.
- What is Bold Legacy Practice, LLC's phone number?
- The practice phone number listed in the NPPES registry for Bold Legacy Practice, LLC is (470) 795-0047.
- Does Bold Legacy Practice, LLC accept Medicare?
- Bold Legacy Practice, 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 Legacy Practice, LLC?
- The authorized official listed on Bold Legacy Practice, LLC's NPPES record is Leia Dawson, Medical Director. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Bold Legacy Practice, LLC's NPI active?
- Yes — Bold Legacy Practice, LLC's NPI (1972212116) is active in the NPPES registry as of the last update on 2024-01-05.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.