Active NPI
Maryellen L Eickman-Fiala, LD
- Registered Dietitian
- Willoughby, OH
National Provider Identifier
1881657765
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- LD1264
- Practice address
- 36000 Euclid Ave
Willoughby, OH 44094-4625 - Phone
- (440) 354-1990
- Fax
- (440) 350-4514
- NPI assigned
- Apr 11, 2006
- Last updated
- Jul 13, 2026
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | LD1264 | OH | Primary |
Addresses
Primary practice location
36000 Euclid Ave
Willoughby, OH 44094-4625
Mailing address
PO Box 714031
Columbus, OH 43271-4031
Phone (440) 716-1283
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LD1264 | OH | MD | Registered Dietitian |
| 1264 | OH | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lake Hospital System | Dietitian, Registered | Past | Accepting new patients |
| Lake Hospital System, Inc | Past | Accepting new patients | |
| Anesthesia Associates, PLL | Past | Accepting new patients |
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
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- Urgent Care Clinic/Center
- Chardon, OH
- NPI 1689634966
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1144713600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1881657765",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 714031",
"city": "COLUMBUS",
"state": "OH",
"postal_code": "432714031",
"telephone_number": "440-716-1283",
"fax_number": "440-716-1605"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "36000 EUCLID AVE",
"city": "WILLOUGHBY",
"state": "OH",
"postal_code": "440944625",
"telephone_number": "440-354-1990",
"fax_number": "440-350-4514"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EICKMAN-FIALA",
"first_name": "MARYELLEN",
"middle_name": "L",
"name_prefix": "Ms.",
"credential": "LD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-04-11",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "OH",
"license": "LD1264",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Willoughby, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.