LOUIS M FULTON (MD) – Child & Adolescent Psychiatry Physician, NPI 1093702383

LOUIS M FULTON (MD) is a healthcare provider. based in Winnebago, Wisconsin. specializing in Child & Adolescent Psychiatry Physician. They hold the professional credentials MD. They hold a License No. 41378 (MN). The NPI Number for LOUIS M FULTON (MD) is 1093702383

Main info

Male
38 Years Of Experience
Accepts Medicare Assignment
Name
LOUIS M FULTON (MD)
NPI
1093702383
Phone
(920) 235-4910
Address
1300 SOUTH DRIVE
Enumeration Date
1 October 2005
Last Update Date
11 May 2018

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6089352776
Graduation Year
1988 (38 years ago)
PAC ID
4082777446
Group Practice PAC ID
0244212959
Professional Enrollment ID
I20090110000206
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:20State licenses:1Digital endpointsOther names

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Provider Addresses for LOUIS M FULTON (MD)

  • Winnebago Mental Health Institute, 1300, South Drive, Oshkosh, Winnebago County, Wisconsin, 54985, United States

    WINNEBAGO, WI 54985

    Phone: (920) 235-4910

    Fax: (920) 237-2043

    Mailing address matches the actual address.

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.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2009-01-10

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20090110000206IPsychiatryWITBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

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 54985)

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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: 0244212959View full group profile
NameSpecialtyState
Nurse PractitionerWI
Clinical Social WorkerWI

Reviews

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Frequently asked questions

What unique ID ties claims to LOUIS M FULTON (MD)?
NPI 1093702383 is assigned to LOUIS M FULTON (MD) under the national enumeration system.
Does this profile mean LOUIS M FULTON (MD) is currently active?
Yes — LOUIS M FULTON (MD) appears active in the national provider directory.
What kind of provider is LOUIS M FULTON (MD)?
The page reflects Child & Adolescent Psychiatry Physician for LOUIS M FULTON (MD). Clinical services aligned with this taxonomy classification.
Does LOUIS M FULTON (MD) practice in Wisconsin?
You will see Winnebago, Wisconsin on file for LOUIS M FULTON (MD) alongside any extra practice locations.
How can I contact LOUIS M FULTON (MD)?
Phone or fax may appear on the official NPI record when supplied — verify before relying on them.

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