QUADRIVIUM HEALTH LLC
NPI 1972212116
Clinic/Center - Urgent Care in Marietta, GA
NPI Status: Active since November 16, 2022
Contact Information
1401 JOHNSON FERRY RD STE 390
MARIETTA, GA
ZIP 30062
Phone: (470) 795-0047
- Organization
- Clinic/Center
- Urgent Care
- CLIA Number: 11D2287873
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 08-17-2025
About QUADRIVIUM HEALTH LLC
This page provides the complete NPI Profile along with additional information for Quadrivium Health Llc, a provider established in Marietta, Georgia operating as a Clinic/center, focusing in urgent care . The healthcare provider is registered in the NPI registry with number 1972212116 assigned on November 2022. The practitioner's primary taxonomy code is 261QU0200X. The provider is registered as an organization and their NPI record was last updated 2 years ago. The provider's is doing business as Quadrivium Health Llc. The authorized official of this NPI record is Dr. Leia Chatman Dawson Do (Medical Director)
- NPI
- 1972212116
- Provider Legal Name
- BOLD LEGACY PRACTICE, LLC
- Other Organization Name
- QUADRIVIUM HEALTH LLC
- Other Name Type
- Doing Business As (3)
- Entity Type
- Organization
- Location Address
- 1401 JOHNSON FERRY RD STE 390 MARIETTA, GA 30062
- Location Phone
- (470) 795-0047
- Mailing Address
- 1117 EAGLES CREEK WAY NW ACWORTH, GA 30101
- Mailing Phone
- (470) 795-0047
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 11-16-2022
- Last Update Date
- 01-05-2024
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Clinic/Center Urgent Care
- Taxonomy Code
- 261QU0200X
- Type
- Ambulatory Health Care Facilities
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 261Q00000X | Ambulatory Health Care Facilities | Clinic/Center |
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 11D2287873
- Facility Type
- Physician Office
- Certificate Effective Date
- August 18, 2023
- Certificate Expiration Date
- August 17, 2025
- Laboratory Director
- LEIA C. DAWSON
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Quadrivium Health Llc to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 9 | 7 | 2 | 2 | 1 | 2 | 1 | 1 | 6 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 9 | 14 | 2 | 4 | 1 | 4 | 1 | 2 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 9 + 1 + 4 + 2 + 4 + 1 + 4 + 1 + 2 + 24 = 54 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 60 - 54 = 6 | 6 | ||||||||
The NPI number 1972212116 is valid because the calculated check digit 6 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 4 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1952083321 | MARJORIE L MCDERMOTT Individual | Nurse Practitioner (Family) | 1401 JOHNSON FERRY RD STE 390 MARIETTA, GA 30062 (470) 250-1492 |
| 1376700989 | LEIA M DAWSON D.O. Individual | Family Medicine | 1401 JOHNSON FERRY RD STE 390 MARIETTA, GA 30062 (470) 250-1492 |
| 1962116392 | BOLD LEGACY PRACTICE, LLC Organization | Clinic/Center | 1401 JOHNSON FERRY RD STE 390 MARIETTA, GA 30062 (470) 795-0047 |
| 1811797236 | ASHEIA RENEE' MERRITT FNP Individual | Nurse Practitioner (Family) | 1401 JOHNSON FERRY RD STE 390 MARIETTA, GA 30062 (470) 250-1492 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1972212116, enumerated in the NPI registry as an "organization" on November 16, 2022
The provider is located at 1401 Johnson Ferry Rd Ste 390 Marietta, Ga 30062 and the phone number is (470) 795-0047
This medical organization specializes in Clinic/Center with taxonomy code 261QU0200X with a focus in Urgent Care
The provider's CLIA number is 11D2287873 for a "physician office" facility with a CLIA Certificate of Waiver. This CLIA certificate is issued to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria..
This NPI record was last updated on November 16, 2022. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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