Individual provider Active NPI

Fred Hughes Coleman III, M.D.

  • Maternal & Fetal Medicine Physician
  • Boise, ID
National Provider Identifier
1891760492
Registry record updated Mar 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Maternal & Fetal Medicine PhysicianTaxonomy code 207VM0101X
License
M-5746 Issued in ID
Practice address
333 N 1St St Ste 150
Boise, ID 83702-6135
Phone
(208) 381-3088
Fax
(208) 381-4314
NPI assigned
Feb 17, 2006
Last updated
Mar 20, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Maternal & Fetal Medicine Physician 207VM0101X M-5746 ID Primary
Maternal & Fetal Medicine Physician 207VM0101X MD11018 OR

Addresses

Primary practice location

333 N 1St St Ste 150
Boise, ID 83702-6135

Mailing address

190 E Bannock St
Boise, ID 83712-6241

Other identifiers 1

IdentifierTypeStateIssuer
288226MedicaidOR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR, WA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20040518000898 OR Practitioner - Obstetrics/Gynecology 2163413352 Reassigns benefits to 1 organization
I20070316000456 WA Practitioner - Obstetrics/Gynecology 2163413352 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
M-5746IDMDMaternal & Fetal Medicine Physician
MD11018ORMDMaternal & Fetal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Vancouver Clinic Inc PS CurrentSince Dec 13, 2021 Accepting new patients
Legacy Salmon Creek Hospital CurrentSince Apr 1, 2007 Accepting new patients
Legacy Salmon Creek Hospital CurrentSince Apr 1, 2007 Accepting new patients
The Vancouver Clinic Inc PS CurrentSince Dec 13, 2021 Accepting new patients
Legacy Clinics LLC Maternal & Fetal Medicine CurrentSince Apr 16, 2004 Accepting new patients
The Vancouver Clinic Inc PS Current Accepting new patients
St. Charles Health System, Inc. Past Accepting new patients
St. Charles Health System, Inc. Past Accepting new patients
St. Charles Health System, Inc. Past Accepting new patients
St. Charles Health System, Inc. Past Accepting new patients

Locations

1130 NW 22nd Ave
Ste 220
Portland, OR 97210
Phone (503) 413-4134

300 N Graham St
Ste 100
Portland, OR 97227
Phone (503) 413-1122

2101 NE 139th St
Ste 2
Vancouver, WA 98686
Phone (360) 487-2870

2211 NE 139th St
Vancouver, WA 98686
Phone (360) 397-1985

2525 NE 139th St
Vancouver, WA 98686
Phone (360) 397-1500

700 NE 87th Ave
Vancouver, WA 98664
Phone (360) 397-1500

Organizations & group practices 10

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.

NPI Registry JSON

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

{
    "created_epoch": "1140134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773964800000",
    "number": "1891760492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "190 E BANNOCK ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837126241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 N 1ST ST STE 150",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837026135",
            "telephone_number": "208-381-3088",
            "fax_number": "208-381-4314"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLEMAN",
        "first_name": "FRED",
        "middle_name": "HUGHES",
        "name_prefix": "Mr.",
        "name_suffix": "III",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-17",
        "last_updated": "2026-03-20",
        "certification_date": "2026-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VM0101X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Maternal & Fetal Medicine",
            "state": "ID",
            "license": "M-5746",
            "primary": true
        },
        {
            "code": "207VM0101X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Maternal & Fetal Medicine",
            "state": "OR",
            "license": "MD11018",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "288226",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boise, ID

Sources for this page

Verify at the official NPI Registry.