Active NPI
Michelle Mae Freshwater, M.D.
- General Practice Physician
- Meridian, ID
National Provider Identifier
1851591879
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Physician
- License
- M-8944
- Practice address
- 3875 E Overland Rd Ste 204
Meridian, ID 83642-9048 - Phone
- (208) 343-3652
- Fax
- (208) 367-9188
- NPI assigned
- Jul 18, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Obesity Medicine (Family Medicine) Physician | 207QB0002X | M-8944 | ID | |
| General Practice Physician | 208D00000X | M-8944 | ID | Primary |
Addresses
Primary practice location
3875 E Overland Rd Ste 204
Meridian, ID 83642-9048
Mailing address
3875 E Overland Rd Ste 204
Meridian, ID 83642-9048
Phone (208) 343-3652
Other practice location 1
133 N Whitley Dr
Fruitland, ID 83619-2430
Phone (208) 739-5679
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Mar 7, 2016 through Mar 7, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| M-8974 | ID | MD | Internal Medicine Physician |
| M-8944 | ID | MD | General Practice Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1184716800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1758153600000",
"number": "1851591879",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3875 E OVERLAND RD STE 204",
"city": "MERIDIAN",
"state": "ID",
"postal_code": "836429048",
"telephone_number": "208-343-3652",
"fax_number": "208-367-9188"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3875 E OVERLAND RD STE 204",
"city": "MERIDIAN",
"state": "ID",
"postal_code": "836429048",
"telephone_number": "208-343-3652",
"fax_number": "208-367-9188"
}
],
"practiceLocations": [
{
"address_1": "133 N Whitley Dr",
"address_purpose": "LOCATION",
"city": "Fruitland",
"state": "ID",
"postal_code": "836192430",
"country_code": "US",
"telephone_number": "208-739-5679",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "FRESHWATER",
"first_name": "MICHELLE",
"middle_name": "MAE",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-07-18",
"last_updated": "2025-09-18",
"certification_date": "2025-09-18",
"status": "A"
},
"taxonomies": [
{
"code": "207QB0002X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Family Medicine, Obesity Medicine",
"state": "ID",
"license": "M-8944",
"primary": false
},
{
"code": "208D00000X",
"taxonomy_group": "",
"desc": "General Practice",
"state": "ID",
"license": "M-8944",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Meridian, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.