Misty Clackum, RD, CSP, LDN
Misty Clackum, RD, CSP, LDN is a Registered Dietitian in Gainesville, GA, registered under NPI 1073944492. This provider registers 3 separate taxonomy codes, which usually means they practise across more than one recognised specialty. NPPES records them as a sole proprietor, meaning the practice is not incorporated as a separate legal entity.
Getting there
The practice address on file is 1814 TREESORT VW, Gainesville, GA 30506. We have not yet mapped what surrounds this office — parking, transit, and nearby pharmacies are added as our data collection reaches each location.
Credentials and Medicare
| Licence | State | Specialty |
|---|---|---|
| LD002340 | GA | Registered Dietitian primary |
| 1250 | TN | Pediatric Nutrition Registered Dietitian |
| LD002340 | GA | Pediatric Nutrition Registered Dietitian |
| LD002340 | GA | Pediatric Critical Care Nutrition… |
Licences are recorded in 2 states: GA, TN. Providers licensed in several states often practise near a state border or deliver telehealth across state lines.
This NPI does not appear in the PECOS Medicare enrolment file. Providers who do not bill Medicare — or who bill only through a group's enrolment — will not appear here. It is not a sign of any problem with the registration.
Licensed in 2 states
This provider holds licences in 2 states: Georgia and Tennessee. The practice address on file is in Gainesville, GA, but a licence in another state usually means they see patients there too — either at a second location or by telehealth. If the address above is far from you, it is worth calling to ask whether they practise closer to where you live.
- Licence
- LD002340
- Specialty
- Registered Dietitian
- Licence
- 1250
- Specialty
- Pediatric Nutrition Registered Dietitian
Licence numbers are self-reported to NPPES at registration. They do not confirm a licence is currently active, in good standing, or valid for the specialty shown — only the state board can tell you that, which is why we link to each one.
What Dietitian, Registered covers
A 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 applications of the Nutrition Care Process (NCP) that exemplify the profession's systematic approach to providing high quality nutrition care. Registered dietitians provide MNT for the purpose of disease prevention or management, or to treat or rehabilitate an illness, injury, or condition, with the use of specific, indicated physical and cognitive nutrition care services comprised of one or more of the following aspects of the NCP: nutrition assessment/reassessment, nutrition diagnosis, nutrition intervention (e.g., nutrition counseling, therapeutic diet ordering, and nutrition education) and nutrition monitoring and evaluation. NUCC Health Care Provider Taxonomy, code 133V00000X
All registered taxonomy codes
This provider registers 4 taxonomy codes. The primary code is what appears on most claims; the others record additional recognised specialties.
| Code | Specialty | Licence | State | |
|---|---|---|---|---|
| 133V00000X | Registered Dietitian | LD002340 | GA | primary |
| 133VN1004X | Pediatric Nutrition Registered Dietitian Nutrition, Pediatric | 1250 | TN | |
| 133VN1004X | Pediatric Nutrition Registered Dietitian Nutrition, Pediatric | LD002340 | GA | |
| 133VN1401X | Pediatric Critical Care Nutrition Registered Dietitian Nutrition, Pediatric Critical Care | LD002340 | GA |
The taxonomy records how the provider classifies their own practice. It does not confirm which conditions they currently treat, whether they are accepting new patients, or which insurance they take — call the office for that.
Full NPPES record
An NPI-1 identifies a single person. It stays with the clinician for life, even if they move practice or change state, which is why the address on file can lag behind where they actually work today.
| NPI | 1073944492 valid check digit |
|---|---|
| Entity type | Individual (NPI-1) |
| Enumeration date | Dec 11, 2013 |
| Last updated | Jul 26, 2025 |
| Status | Active |
| Sole proprietor | Yes |
| Credential | RD, CSP, LDN |
| Practice address |
1814 TREESORT VW Gainesville, GA 30506 (423) 284-5512 Fax (770) 470-0770 |
| Other identifiers |
Q038482
(TN) |
Number check
How the check works, step by step
Every NPI carries a Luhn check digit — the same scheme used on credit cards. CMS prefixes the number with 80840 before computing it, which marks it as a US health identifier.
| Digit | 8 | 0 | 8 | 4 | 0 | 1 | 0 | 7 | 3 | 9 | 4 | 4 | 4 | 9 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Doubled? | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 |
| Value | 8 | 0 | 8 | 8 | 0 | 2 | 0 | 5 | 3 | 9 | 4 | 8 | 4 | 9 |
Sum = 68 · next multiple of 10 = 70 · check digit = 2 · actual last digit = 2
A valid check digit only means the number is well-formed. It does not mean the provider is licensed, active, or in good standing — those are separate questions answered by the sections above.