Individual provider Active NPI

Cynthia Rena Kohliem, FNP-C

  • Family Nurse Practitioner
  • Sherman, MS
National Provider Identifier
1710315387
Registry record updated Oct 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
875837 Issued in MS
Practice address
PO Box 212
Sherman, MS 38869-0212
Phone
(662) 255-0382
NPI assigned
Oct 17, 2013
Last updated
Oct 24, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2025

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 875837 MS Primary

Addresses

Primary practice location

PO Box 212
Sherman, MS 38869-0212

Mailing address

118 Fairfield Dr
New Albany, MS 38652-3107
Phone (662) 534-0898

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140306000063 MS Practitioner - Nurse Practitioner 9830329184 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

118 Fairfield Dr
New Albany, MS 38652-3107

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Internal Medicine and Pediatric Clinic of New Albany, PLLC CurrentSince May 12, 2025 Accepting new patients
Internal Medicine and Pediatric Clinic of New Albany, PLLC Family CurrentSince Apr 27, 2025 Accepting new patients

Locations

118 Fairfield Dr
New Albany, MS 38652
Phone (662) 534-0898

119 City Market Dr
Saltillo, MS 38866
Phone (662) 534-0898

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1381968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761264000000",
    "number": "1710315387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "118 FAIRFIELD DR",
            "city": "NEW ALBANY",
            "state": "MS",
            "postal_code": "386523107",
            "telephone_number": "662-534-0898",
            "fax_number": "662-534-8905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "PO BOX 212",
            "city": "SHERMAN",
            "state": "MS",
            "postal_code": "388690212",
            "telephone_number": "662-255-0382"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOHLIEM",
        "first_name": "CYNTHIA",
        "middle_name": "RENA",
        "name_prefix": "Dr.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-10-17",
        "last_updated": "2025-10-24",
        "certification_date": "2025-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "875837",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sherman, MS

Sources for this page

Verify at the official NPI Registry.