Amanda Sue Al-Khudairi, MSN, RNC, APRN

Primary specialty

Women's Health Nurse PractitionerTaxonomy code 363LW0102X

License

372242-4405 Issued in UT

Practice address

1906 W 3600 S
Salt Lake City, UT 84119-4715

Phone

(801) 973-9675

NPI assigned

May 1, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in UT

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing, Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: aalkhudairi2540@direct.med.utah.edu
• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

• University of Utah Adult Services

  • General Practice Physician
  • Salt Lake City, UT
  • NPI 1114321981
  Medicare reassignment NPD
• University of Utah Community Physicians Group

  • Family Medicine Physician
  • Salt Lake City, UT
  • NPI 1467241554
  Medicare reassignment
• University of Utah Adult Services

  • Neurology Physician
  • Salt Lake City, UT
  • NPI 1578967345
  NPD
• University of Utah Adult Services

  • Diagnostic Radiology Physician
  • Salt Lake City, UT
  • NPI 1598169419
  NPD
• University of Utah Community Physicians Group

  • Family Medicine Physician
  • Park City, UT
  • NPI 1053715763
  NPD
• University of Utah Community Physicians Group

  • General Practice Physician
  • Salt Lake City, UT
  • NPI 1124422126
  NPD
• University of Utah Community Physicians Group

  • Family Medicine Physician
  • Stansbury PK, UT
  • NPI 1497159107
  NPD
• Planned Parenthood Association of Utah

  • Voluntary or Charitable Agency
  • Salt Lake City, UT
  • NPI 1073549614
  NPD (past)
• Planned Parenthood Association of Utah

  • Clinic Pharmacy
  • West Valley City, UT
  • NPI 1881010874
  NPD (past)

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

{
    "created_epoch": "1177977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634342400000",
    "number": "1861613242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6900 S 800 E",
            "city": "MIDVALE",
            "state": "UT",
            "postal_code": "840471431",
            "telephone_number": "801-569-9363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1906 W 3600 S",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841194715",
            "telephone_number": "801-973-9675"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AL-KHUDAIRI",
        "first_name": "AMANDA",
        "middle_name": "SUE",
        "name_prefix": "Mrs.",
        "credential": "MSN, RNC, APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-01",
        "last_updated": "2021-10-16",
        "certification_date": "2021-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "UT",
            "license": "372242-4405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "aalkhudairi2540@direct.med.utah.edu",
            "affiliation": "Y",
            "affiliationName": "University of Utah",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "50 N Medical Dr",
            "city": "Salt Lake City",
            "state": "UT",
            "country_code": "US",
            "postal_code": "841320001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Ahmed Al Ameri
• Badiya Al Dujaili
• Shaymaa Al Dujaili
• Sarah Al Mafraji
• Ghaida Al-Barzinji, PA-C
• Sajaad Kayden Al-Mosawi
• Mohmmad Baqar Al-Saedy
• Alisa Al-Sharif
• Dharshan Alaguretnam
• Jordan Alailima

• Women's Health Nurse Practitioner in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Women's Health Nurse Practitioner in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.