NPI age
3 years
Enumerated 2022-11-16
● Active Type 2 · Organization
Bold Legacy Practice, Llc
Bold Legacy Practice, Llc is 1 of 354 clinic/center organizations in Georgia.
Primary specialty
Clinic/Center
Plus 1 secondary
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
Dawson
Medical Director
Last NPPES update
2024-01-05
Source: monthly bulk 2026-05
How this organization compares
Across 354 active clinic/center providers in Georgia.
NPI age
3 years
↓ 7 yr below median
Practice locations
1
0 secondary on file
Subspecialties
1
In the 22% of peers with subspecialties
NPI lifetime · 2022 → 2026
2022-11Enumerated in NPPES
2022
2026
Where they practice
Primary practice location
1401 Johnson Ferry Rd Ste 390
Marietta, GA 300629100
Mailing address
1117 Eagles Creek Way Nw
Acworth, GA 301014696
Authorized official
Leia Chatman Dawson, DO
Medical Director
📞 2059075342
Individual providers at this organization
3 individual providers on file at this primary practice address.
- Leia Dawson, D.O. Family Medicine NPI 1376700989
- Marjorie McDermott Nurse Practitioner NPI 1952083321
- Asheia Merritt, FNP Nurse Practitioner NPI 1811797236
Specialties
-
Clinic/Center PrimaryDefinition to come...
-
Clinic/CenterA facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct...
Other names on file (4)
Doing-business-as, former, and alternate names recorded by NPPES.
-
American Family Care
-
Bold Legacy Management, LLC
-
Quadrivium Health LLC
-
Quadrivium Health LLC
Practice context
Multi-provider organization. 3 individual providers on file at this primary address.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
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