Bold Legacy Practice, LLC in Marietta, GA
This location of Bold Legacy Practice bills under NPI 1962116392, an organization record issued on Jan 10, 2023 with the primary taxonomy Clinic/Center. It is one of 2 NPIs registered under this name and one of 2 in Marietta; each clinician who sees you there has their own NPI and license.
- Legal name
- Bold Legacy Practice, LLC
- Entity
- Type 2 · organization
- Primary taxonomy
- Clinic/Center 261Q00000X
- Practice location
- 1401 JOHNSON FERRY RD STE 390, Marietta, GA 30062
- Phone
- 470-795-0047
- Mailing address
- Acworth, GA
- Enumerated
- Jan 10, 2023
- Record updated
- Dec 28, 2023
- Authorized official
- Medical Director (title as filed)
The other Marietta NPI
- Bold Legacy Practice, LLC1401 JOHNSON FERRY RD STE 390 · issued Nov 16, 20221972212116
3 clinicians CMS lists with Bold Legacy Practice in Marietta
- Leia Dawson, DOFamily Medicine Physician1376700989
- Elleni Kebede, NPFamily Nurse Practitioner1124711064
- Asheia Merritt, FNPFamily Nurse Practitioner1811797236
Source: CMS Doctors and Clinicians group affiliations, matched by practice name and city.
Every location registered under this name, in 1 city.
See every locationChecking an organization
- Confirm the business with the Georgia secretary of state.
- Check the HHS-OIG exclusion list for the organization.
- Verify each clinician on their own record and the state license search.
Common questions
Is an organization NPI a license?
No. An NPI identifies who bills. Facilities and the clinicians who work there are licensed separately by the state.
Which Marietta NPI should I use?
Ask the office which NPI it bills under; all 2 Marietta NPIs are registered under the same name.
Source: CMS National Plan and Provider Enumeration System (NPPES), monthly file of Aug 9, 2026 (NPPES files on CMS.gov). An NPI identifies who bills; it is not a license.