Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mrs. Theresa S. Clark, MSRD, CDE, LD

Individual provider Registered Dietitian · NPI 1013120948

Mrs. Theresa S. Clark, MSRD, CDE, LD is a Registered Dietitian OR Nutrition Professional in Hopkinsville, Kentucky. Qualified in 1987, 39 years ago. Practices as a sole proprietor and accepts Medicare assignment. Licensed in Kentucky.

Years since qualifying
39
Licensed in
KY
In the registry since
2007
What do these letters mean?
CDE — Certified Diabetes Educator
Teaches people to manage diabetes day to day.
LD — Licensed Dietitian
A dietitian licensed by a state board.

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Practice location Address checks out

530 Noel Ave
Hopkinsville, KY 42240-1386
Phone: (270) 707-0060
Fax: (270) 707-0068
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Registered Dietitian (primary) Taxonomy 133V00000X · Licence KY-0517 (KY)

Record details

NPI number1013120948
Entity typeIndividual (Type 1)
GenderFemale
Credentials MSRD , CDE , LD
Sole proprietorYes
NPI enumeratedMay 7, 2007
Last updated in NPPESAugust 5, 2016

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyREGISTERED DIETITIAN OR NUTRITION PROFESSIONAL
Medical schoolOTHER
Graduated 1987 (39 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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