Bold Primary LLC
NPI 1275300287ActiveOrganization· Family Medicine· Marietta, GA
Family Medicine in Marietta, Georgia, registered in NPPES in December 2023. The authorized official on file is Leia Dawson, DO, Medical Director/ Executive Officer. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1275300287 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Dec 8, 2023 |
| Last updated in NPPES | May 13, 2024 |
| Certified by provider | May 13, 2024 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Family Medicine Primary | 207Q00000X | — | — |
| Clinic/Center | 261Q00000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (GA) |
|---|
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