Individual provider Active NPI

Tyra Lashay Bennett, NP

  • Family Nurse Practitioner
  • Thomasville, GA
National Provider Identifier
1144081571
Registry record updated Nov 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN234059 Issued in GA
Practice address
706 S Broad St
Thomasville, GA 31792-6107
Phone
(229) 228-2407
NPI assigned
Jan 22, 2024
Last updated
Nov 18, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 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 RN234059 GA Primary

Addresses

Primary practice location

706 S Broad St
Thomasville, GA 31792-6107

Mailing address

706 S Broad St
Thomasville, GA 31792-6107
Phone (229) 328-4181

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20250423000929 GA Practitioner - Nurse Practitioner 7315462231 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Archbold Medical Group, Inc.Group PAC ID 8123196383, 80 clinicians

Practice addresses (Care Compare)

706 S Broad St
Thomasville, GA 31792-6107
Phone (229) 228-2400

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Archbold Medical Group, Inc. CurrentSince Mar 15, 2025 Accepting new patients
Archbold Medical Group, Inc. CurrentSince Mar 15, 2025 Accepting new patients

Locations

100 Mimosa Dr
Thomasville, GA 31792
Phone (229) 226-9141

706 S Broad St
Thomasville, GA 31792
Phone (229) 228-2400

900 Cairo Rd
Thomasville, GA 31792
Phone (229) 227-5102

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.

Hospital & facility affiliations 2

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": "1705881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763424000000",
    "number": "1144081571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "706 S BROAD ST",
            "city": "THOMASVILLE",
            "state": "GA",
            "postal_code": "317926107",
            "telephone_number": "229-328-4181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "706 S BROAD ST",
            "city": "THOMASVILLE",
            "state": "GA",
            "postal_code": "317926107",
            "telephone_number": "229-228-2407"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENNETT",
        "first_name": "TYRA",
        "middle_name": "LASHAY",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-01-22",
        "last_updated": "2025-11-18",
        "certification_date": "2025-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN234059",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Thomasville, GA

Sources for this page

Verify at the official NPI Registry.