NPI age
12 years
Enumerated 2013-12-11
● Active
Type 1 · Individual
MRS. Misty Mullins Clackum, RD, CSP, LDN
Clackum is 1 of 20 dietitian, registered providers in Gainesville and 1 of 1653 in Georgia.
Primary specialty
Dietitian, Registered
Plus 3 subspecialties
Licensed in
GA, TN
2 states
Status
Active
No deactivations on record
Last NPPES update
2025-07-26
Source: monthly bulk 2026-05
Sole proprietor
Yes
Solo practice on file
How this provider compares
Across 1653 active dietitian, registered providers in Georgia.
NPI age
12 years
↑ 5 yr above median (7 yr)
State licenses
2 states
Top 95% — 4% of peers are multi-state
Subspecialties
2
In the 10% of peers with subspecialties
NPI lifetime · 2013 → 2026
2013-12Enumerated in NPPES
2013
2026
Where they practice
Practice location
1814 Treesort Vw
Gainesville, GA 305065383
Mailing address
1814 Treesort Vw
Gainesville, GA 305065383
Specialties
-
Dietitian, Registered PrimaryA Registered Dietitian (RD)/Registered Dietitian Nutritionist (RDN) is an individual uniquely trained in the science of nutrition and practice of dietetics to design and provide medical nutrition therapy (MNT) and other evidence-based...
-
Dietitian, RegisteredAn individual who is a Board Certified Specialist in Pediatric Nutrition and applies evidence-based nutrition knowledge in providing medical nutrition therapy for pediatric patients. Specialists work directly with healthy and/or ill...
-
Dietitian, RegisteredAn individual who is a Board Certified Specialist in Pediatric Critical Care Nutrition and applies evidence-based nutrition knowledge in providing medical nutrition therapy for critically ill infants, children and adolescents....
Identifiers
| Type | Value | Notes |
|---|---|---|
| 05 (TN) | Q038482 |
Multi-state credentialing: Licensed in 2 states. Useful context for credentialers building cross-state provider networks.
Practice context
Part of a multi-provider practice. 1 other active provider shares this practice address in NPPES.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
- Check the state license is currently active.State licensing boards publish current status; NPPES does not.
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