Miriam Eackloff, RD

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

86101057 Issued in VA

Practice address

5510 Alma LN Ste 300
Springfield, VA 22151-4028

Phone

(703) 642-5990

NPI assigned

Sep 15, 2019

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in DC

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Boundless Nutrition LLC

  • Clinic/Center
  • Fairfax, VA
  • NPI 1033828694

  DC

  Medicare reassignment NPD Authorized official
• Virginia Medical Alliance PC

  • Internal Medicine Physician
  • Springfield, VA
  • NPI 1225083223

  DC

  Medicare reassignment NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1568505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667779200000",
    "number": "1427608165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13112 MOSS RANCH LN",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220333524",
            "telephone_number": "703-887-9750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5510 ALMA LN STE 300",
            "city": "SPRINGFIELD",
            "state": "VA",
            "postal_code": "221514028",
            "telephone_number": "703-642-5990"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13112 Moss Ranch Ln",
            "address_purpose": "LOCATION",
            "city": "Fairfax",
            "state": "VA",
            "postal_code": "220333524",
            "country_code": "US",
            "telephone_number": "703-887-9750",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EACKLOFF",
        "first_name": "MIRIAM",
        "credential": "RD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-09-15",
        "last_updated": "2022-11-07",
        "certification_date": "2022-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "VA",
            "license": "86101057",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• William James Dunwoody, M.D.
• Tiffany Duong
• Laurie Dupuis, PSY.D.
• Nima Dutt
• Carl Dzyak, M.ED., BCBA
• Ear Nose & Throat Specialists of Northern VA
• Nancy F Earle, MSPT
• Bryce Earley
• Damien Ian Eyre Eastman, PHARMD
• Nelya Ebadirad, MD

• Registered Dietitian in Springfield, VA
• Providers in Springfield, VA by specialty
• Registered Dietitian in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.