Kourtney Anna Chaires, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

CNP-02110 Issued in NM

Practice address

1363 Aberdeen Ave
White Sands Missile Range, NM 88002

Phone

(575) 674-3500

Fax

(915) 742-7459

NPI assigned

Oct 31, 2012

Last updated

Feb 12, 2025By the provider in NPPES

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

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://epicproxy.et1256.epichosted.com/FHIRProxy/api/FHIR/R4/

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.

• Ben Archer Health Center

  • Federally Qualified Health Center (FQHC)
  • Truth Or Consequences, NM
  • NPI 1871528505
  Medicare reassignment NPD
• Ben Archer Health Center

  • Federally Qualified Health Center (FQHC)
  • Hatch, NM
  • NPI 1154352532
  NPD
• Ben Archer Health Center

  dba Ben Archer Health Center Deming School Base

  • Federally Qualified Health Center (FQHC)
  • Deming, NM
  • NPI 1194443135
  NPD

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

{
    "created_epoch": "1351641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739318400000",
    "number": "1497009203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 370",
            "city": "HATCH",
            "state": "NM",
            "postal_code": "879370370",
            "telephone_number": "575-267-3280",
            "fax_number": "575-267-1747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1363 ABERDEEN AVE",
            "city": "WHITE SANDS MISSILE RANGE",
            "state": "NM",
            "postal_code": "88002",
            "telephone_number": "575-674-3500",
            "fax_number": "915-742-7459"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAIRES",
        "first_name": "KOURTNEY",
        "middle_name": "ANNA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-31",
        "last_updated": "2025-02-12",
        "certification_date": "2025-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NM",
            "license": "CNP-02110",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• AMC William Beaumont-Ft Bliss (Dod White Sands Pharmacy)
• Michael Beckler, MSW
• Christine Benson, RN
• Lawrence Daniel Eres, LCSW, LADAC
• Alexander Haug, ARMY X2
• National Vision Optical
• William Beaumont Army Medical Center (Ahc McAfee)
• William Beaumont Army Medical Center (TMC McGregor Range)

• Family Nurse Practitioner in White Sands Missile Range, NM
• Providers in White Sands Missile Range, NM by specialty
• Family Nurse Practitioner in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2025; 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.