Bold Legacy Practice, LLC

Bold Legacy Practice, LLC is a healthcare organization registered as Clinic/Center in Marietta, GA, holding Type 2 (organization) NPI 1962116392 since 2023. The authorized official on file is Leia Dawson, Medical Director.

✓ Active NPI ✓ Valid NPI checksum

NPI	1962116392
Entity type	Organization (Type 2)
Legal business name	Bold Legacy Practice, LLC
Practice address	1401 JOHNSON FERRY RD STE 390, Marietta, GA, 30062
Phone	4707950047
Enumeration date	2023-01-10
Last updated in NPPES	2023-12-28

Authorized official

Name	Leia Dawson
Title	Medical Director
Phone	4707950047

Taxonomy & classification

Taxonomy code	Specialty	Primary	License	State
261Q00000X	Clinic/Center	Primary	—	—

Copy-ready billing details

Provider: Bold Legacy Practice, LLC
NPI: 1962116392
Taxonomy: 261Q00000X (Clinic/Center)
Address: 1401 JOHNSON FERRY RD STE 390, Marietta, GA, 30062

Providers at this address

NPI	Name	Type	Specialty	Location
1376700989	Leia Dawson	Individual	Family Medicine Physician	Marietta, GA
1972212116	Bold Legacy Practice, LLC	Organization	Urgent Care Clinic/Center	Marietta, GA
1952083321	Marjorie Mcdermott	Individual	Family Nurse Practitioner	Marietta, GA
1811797236	Asheia Merritt	Individual	Family Nurse Practitioner	Marietta, GA

Verify this record

Cross-check NPI 1962116392 against the authoritative CMS record: view Bold Legacy Practice, LLC on the official NPPES registry .

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes — even if the provider moves or changes specialty. Read the full guide or validate an NPI number.

Frequently asked questions

Where is Bold Legacy Practice, LLC located?

The practice location on file with NPPES is in Marietta, GA.

How current is this record?

Data comes from the CMS NPPES public dissemination file; this record was last updated in NPPES on 2023-12-28. Verify at npiregistry.cms.hhs.gov.

Source: CMS NPPES (public data). Snapshot 2026-07-11. Provider record last updated 2023-12-28.