Individual provider Active NPI

Eric Soucy Rueff, D.O.

  • Child & Adolescent Psychiatry Physician
  • Appleton, WI
National Provider Identifier
1891085130
Registry record updated Mar 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
License
65935-21 Issued in WI
Practice address
4321 W College Ave Ste 200
Appleton, WI 54914-3968
Phone
(920) 882-7780
Fax
(920) 214-1187
NPI assigned
Apr 7, 2011
Last updated
Mar 20, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

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
Psychiatry Physician 2084P0800X 65935-21 WI
Child & Adolescent Psychiatry Physician 2084P0804X 65935-21 WI Primary

Addresses

Primary practice location

4321 W College Ave Ste 200
Appleton, WI 54914-3968

Mailing address

4321 W College Ave Ste 200
Appleton, WI 54914-3968
Phone (920) 882-7780

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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 1

Enrollment IDStateProvider typePAC IDDetails
I20161116001560 WI Practitioner - Psychiatry 7719125293 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Michigan State University College of Osteopathic Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4321 W College Ave
Suite 200
Appleton, WI 54914-3968
Phone (920) 882-7780

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
65935-21WIMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Fox Valley Psychiatry LTD. Psychiatry CurrentSince Nov 25, 2025 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

4321 W College Ave
Ste 200
Appleton, WI 54914
Phone (920) 519-2920

4650 W Spencer St
Appleton, WI 54914
Phone (920) 903-1060

Organizations & group practices 2

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": "1302134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773964800000",
    "number": "1891085130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4321 W COLLEGE AVE STE 200",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549143968",
            "telephone_number": "920-882-7780",
            "fax_number": "920-214-1187"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4321 W COLLEGE AVE STE 200",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549143968",
            "telephone_number": "920-882-7780",
            "fax_number": "920-214-1187"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUEFF",
        "first_name": "ERIC",
        "middle_name": "SOUCY",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-04-07",
        "last_updated": "2026-03-20",
        "certification_date": "2026-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "WI",
            "license": "65935-21",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "WI",
            "license": "65935-21",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Appleton, WI

Sources for this page

Verify at the official NPI Registry.