Individual provider Active NPI

Connie Wunderly, RN

  • Registered Nurse
  • Gainesville, FL
National Provider Identifier
1609548239
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
9512692 Issued in FL
Practice address
8623 SW 10TH Rd
Gainesville, FL 32607-4933
Phone
(615) 525-1021
NPI assigned
Oct 1, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 9512692 FL Primary

Addresses

Primary practice location

8623 SW 10TH Rd
Gainesville, FL 32607-4933

Mailing address

8623 SW 10TH Rd
Gainesville, FL 32607-4933
Phone (615) 525-1021

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
9512692FLMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1633046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1609548239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8623 SW 10TH RD",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326074933",
            "telephone_number": "615-525-1021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8623 SW 10TH RD",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326074933",
            "telephone_number": "615-525-1021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WUNDERLY",
        "first_name": "CONNIE",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-01",
        "last_updated": "2026-07-13",
        "certification_date": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "FL",
            "license": "9512692",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.