Individual provider Active NPI

Kalie Fairclough, NP

  • Family Nurse Practitioner
  • Las Cruces, NM
National Provider Identifier
1053279380
Registry record updated Mar 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
56472 Issued in NM
Practice address
3485 Northrise Dr
Las Cruces, NM 88011-6839
Phone
(575) 382-2149
NPI assigned
Jan 14, 2026
Last updated
Mar 27, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 56472 NM Primary

Addresses

Primary practice location

3485 Northrise Dr
Las Cruces, NM 88011-6839

Mailing address

3485 Northrise Dr Ste 2
Las Cruces, NM 88011-6839
Phone (575) 382-2149

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
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

Enrollment IDStateProvider typePAC IDDetails
I20260410000718 NM Practitioner - Nurse Practitioner 6901371616 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

PO Box
Franklin, TN 37068

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
56472NMMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Las Cruces Physician Services LLC CurrentSince May 1, 2026 Accepting new patients

Locations

3485 Northrise Dr
Ste 1
Las Cruces, NM 88011
Phone (575) 382-2161

3485 Northrise Dr
Ste 2
Las Cruces, NM 88011
Phone (575) 382-2149

Organizations & group practices 1

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1768348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774569600000",
    "number": "1053279380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3485 NORTHRISE DR STE 2",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880116839",
            "telephone_number": "575-382-2149"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3485 NORTHRISE DR",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880116839",
            "telephone_number": "575-382-2149"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAIRCLOUGH",
        "first_name": "KALIE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-01-14",
        "last_updated": "2026-03-27",
        "certification_date": "2026-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NM",
            "license": "56472",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Cruces, NM

Sources for this page

Verify at the official NPI Registry.