Individual provider Active NPI

Hillary D Wynn, MD

  • Child & Adolescent Psychiatry Physician
  • Wauwatosa, WI
National Provider Identifier
1871600767
Registry record updated Aug 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
License
C211233 Issued in CA
Practice address
2600 N Mayfair Rd Ste 400
Wauwatosa, WI 53226-1306
Phone
(414) 232-8397
Fax
(888) 297-5852
NPI assigned
Aug 24, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 27, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 47257-020 WI
Child & Adolescent Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0804X 47257-020 WI
Child & Adolescent Psychiatry Physician 2084P0804X C211233 CA Primary
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X C211233 CA

Addresses

Primary practice location

2600 N Mayfair Rd Ste 400
Wauwatosa, WI 53226-1306

Mailing address

2600 N Mayfair Rd Ste 400
Wauwatosa, WI 53226-1306
Phone (414) 232-8397

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
I20041019000524 WI Practitioner - Psychiatry 0648230136 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
47257-020WIMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Center for Integrative Psychiatric Care, LLC Current Accepting new patients
Ascension Medical Group-Fox Valley Wisconsin, Inc CurrentSince Jun 25, 2024 Accepting new patients
Ascension Medical Group-Fox Valley Wisconsin, Inc CurrentSince Jun 25, 2024 Accepting new patients

Locations

1506 S Oneida St
Appleton, WI 54915
Phone (920) 730-4950

1501 S Madison St
Appleton, WI 54915
Phone (920) 730-4435

459 E 1st St
Fond du Lac, WI 54935
Phone (920) 929-3500

2700 W 9th Ave
Oshkosh, WI 54904
Phone (920) 223-0220

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1156377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787788800000",
    "number": "1871600767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2600 N MAYFAIR RD STE 400",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "532261306",
            "telephone_number": "414-232-8397",
            "fax_number": "888-297-5852"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 N MAYFAIR RD STE 400",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "532261306",
            "telephone_number": "414-232-8397",
            "fax_number": "888-297-5852"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYNN",
        "first_name": "HILLARY",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-24",
        "last_updated": "2026-08-27",
        "certification_date": "2026-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "WI",
            "license": "47257-020",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "WI",
            "license": "47257-020",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "CA",
            "license": "C211233",
            "primary": true
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "C211233",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wauwatosa, WI

Sources for this page

Verify at the official NPI Registry.