DWIGHT E FULTZ (PHD, LP) – Psychologist, NPI 1033628805

DWIGHT E FULTZ (PHD, LP) is a healthcare provider. based in Bemidji, Minnesota. specializing in Psychologist. They hold the professional credentials PHD, LP. They hold a License No. LP4277 (MN). The NPI Number for DWIGHT E FULTZ (PHD, LP) is 1033628805

Main info

Male
Sole Proprietor
35 Years Of Experience
Accepts Medicare Assignment
Name
DWIGHT E FULTZ (PHD, LP)
NPI
1033628805
Phone
(218) 751-1811
Address
2310 S LAKE IRVING DR SW
Enumeration Date
25 September 2017
Last Update Date
25 September 2017

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2183662636
Graduation Year
1991 (35 years ago)
PAC ID
9830452671
Group Practice PAC ID
5991017402
Professional Enrollment ID
I20180410000482
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience30
Completeness75
Years active:8State licenses:1Digital endpointsOther names

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Provider Addresses for DWIGHT E FULTZ (PHD, LP)

  • 2310, South Lake Irving Drive Southwest, Bemidji, Beltrami County, Minnesota, 56601, United States

    BEMIDJI, MN 566018859

    Phone: (218) 751-1811

    Type: Mailing

  • 1003, Hollinger Street, Park Rapids, Hubbard County, Minnesota, 56470, United States

    PARK RAPIDS, MN 564701300

    Phone: (218) 366-2636

    Fax: (218) 366-2087

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 56601)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 5991017402View full group profile
NameSpecialtyState
Clinical Social WorkerMN
-NV
Clinical Social WorkerMN

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Frequently asked questions

What federal number belongs to DWIGHT E FULTZ (PHD, LP)?
The federal identifier for DWIGHT E FULTZ (PHD, LP) is NPI 1033628805.
Is DWIGHT E FULTZ (PHD, LP) currently active in the NPI registry?
CMS-published data lists DWIGHT E FULTZ (PHD, LP) as an active registrant.
Does DWIGHT E FULTZ (PHD, LP) list a primary specialty?
If you are matching referrals, note Psychologist for DWIGHT E FULTZ (PHD, LP). Clinical services aligned with this taxonomy classification.
Where does public data place DWIGHT E FULTZ (PHD, LP)?
The snapshot lists Bemidji, Minnesota for DWIGHT E FULTZ (PHD, LP); download NPPES for the complete set.
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

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