Mrs Misty Mullins Clackum, RD, CSP, LDN - Dietitian in Gainesville, GA

Mrs Misty Mullins Clackum, RD, CSP, LDN is a Dietitian, Registered - Nutrition, Pediatric based in Gainesville, Georgia. Mrs Misty Mullins Clackum is licensed to practice in Georgia (license number LD002340) and her current practice location is 3869 Berkshire Ridge Dr, Gainesville, Georgia. She can be reached at her office (for appointments etc.) via phone at (423) 284-5512.

NPI number for Mrs Misty Mullins Clackum is 1073944492 and her current mailing address is 3869 Berkshire Ridge Dr, Gainesville, Georgia. She does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1073944492.

Contact Information

Mrs Misty Mullins Clackum, RD, CSP, LDN
3869 Berkshire Ridge Dr,
Gainesville, GA 30506-4560
(423) 284-5512
Not Available

Map and Direction




Healthcare Provider's Profile

Full NameMrs Misty Mullins Clackum
GenderFemale
SpecialityDietitian, Registered - Nutrition, Pediatric
Location3869 Berkshire Ridge Dr, Gainesville, Georgia
Accepts Medicare AssignmentsDoes not participate in Medicare Program. She may not accept medicare assignment.
  NPI Data:
  • NPI Number: 1073944492
  • Provider Enumeration Date: 12/11/2013
  • Last Update Date: 06/06/2023

Medical Identifiers

Medical identifiers for Mrs Misty Mullins Clackum such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1073944492NPI-NPPES
Q038482MedicaidTN

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
133V00000XDietitian, Registered LD002340 (Georgia)Secondary
133VN1004XDietitian, Registered - Nutrition, Pediatric 1250 (Tennessee)Secondary
133VN1401XDietitian, Registered - Nutrition, Pediatric Critical Care LD002340 (Georgia)Secondary
133VN1004XDietitian, Registered - Nutrition, Pediatric LD002340 (Georgia)Primary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mrs Misty Mullins Clackum is NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Mrs Misty Mullins Clackum, RD, CSP, LDN
3869 Berkshire Ridge Dr,
Gainesville, GA 30506-4560

Ph: (423) 284-5512
Mrs Misty Mullins Clackum, RD, CSP, LDN
3869 Berkshire Ridge Dr,
Gainesville, GA 30506-4560

Ph: (423) 284-5512

Reviews and Comments


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Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

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