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BOLD ARK LLC
NPI 1740079623
Nurse Practitioner - Psychiatric/Mental Health in Loganville, GA

Active since May 06, 2025
3905 HARRISON RD STE 500, LOGANVILLE, GA 30052(678) 898-1927(678) 798-8880 Get Directions Write a Review

NPPES record last updated: March 27, 2026. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Mar 27, 2026, May 6, 2025 (2 updates tracked since 2025).

About Bold Ark Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BOLD ARK LLC (NPI 1740079623) is a healthcare organization registered as a psychiatric/mental health in Loganville, Georgia and active in the NPI registry since May 2025. The organization lists Olufunke Mukomi Adewunmi, Ceo, as its authorized official.

NPPES Registry Identity

NPI1740079623
Entity TypeOrganization
Primary Taxonomy363LP0808X
Legal Business NameBOLD ARK LLC
Location Address3905 HARRISON RD STE 500Loganville, GA 30052-5895
Mailing Address3905 Harrison Rd Ste 500Loganville, GA 30052-5895 · (678) 898-1927 · Fax (678) 798-8880
Phone(678) 898-1927
Fax(678) 798-8880
Organization SubpartNo
Authorized OfficialOlufunke Mukomi AdewunmiCeo · (678) 898-1927
Enumeration DateMay 6, 2025
Last NPPES UpdateMarch 27, 20262 updates tracked since enumeration
NPPES CertifiedMarch 27, 2026
✔ NPI 1740079623 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0808X
3905 HARRISON RD STE 500, Loganville, GA 30052
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

GIFTED HANDS MIDWIFERY
Advanced Practice Midwife
3905 HARRISON RD STE 500
LOGANVILLE, GA 30052
Gwinnett County (470) 504-3856
NATASHA GILES PMHNP
Nurse Practitioner (Psychiatric/Mental Health)
3905 HARRISON RD STE 500
LOGANVILLE, GA 30052
Gwinnett County (404) 849-2344

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Bold Ark LLC's NPI number?

The NPI number for Bold Ark LLC is 1740079623. It was assigned to this organization in the NPPES registry on May 6, 2025.

Where is Bold Ark LLC located?

Bold Ark LLC is located at 3905 Harrison Rd Ste 500, Loganville, GA 30052. The listed phone number is (678) 898-1927.

What is Bold Ark LLC's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

When was this NPI record last updated?

The NPPES record for Bold Ark LLC was last updated on March 27, 2026. NPI Profile syncs with the weekly NPPES data releases published by CMS.