MITZI BRADDOCK TYRE FNP
NPI 1396983227
Nurse Practitioner - Psychiatric/Mental Health in Waycross, GA

Active since January 30, 2009PECOS EnrolledAccepts Medicare Assignment
1007 MARY ST, WAYCROSS, GA 31503(912) 387-7737(912) 449-7080 Get Directions Write a Review

NPPES record last updated: August 20, 2024. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Mitzi Braddock Tyre Fnp NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MITZI BRADDOCK TYRE FNP (NPI 1396983227) is an individual psychiatric/mental health provider in Waycross, Georgia, licensed in Georgia (RN170702) and active in the NPI registry since January 2009. She is enrolled in Medicare PECOS, maintains a secondary practice location in Savannah, and is a graduate of Other (2020).

NPPES Registry Identity

NPI1396983227
Entity TypeIndividualFemale
Primary Taxonomy363LP0808X
Provider Legal NameMITZI BRADDOCK TYRECredential: FNP
Location Address1007 MARY STWaycross, GA 31503-3823
Mailing Address2900 Mossy Oak TrlWaycross, GA 31503-4621 · (912) 387-7737
Fax(912) 449-7080
Sole ProprietorYes
Medical School CMSOtherGraduated 2020
Enumeration DateJanuary 30, 2009
Last NPPES UpdateAugust 20, 2024
NPPES CertifiedAugust 20, 2024
NPI 1396983227 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0808X
License Licensed in GA · RN170702
Also ListedRegistered NurseTaxonomy 163W00000X · License RN170702 (GA)
Also ListedNurse Practitioner · FamilyTaxonomy 363LF0000X · License RN170702 (GA)
1007 MARY ST, Waycross, GA 31503

Other Names 1

Other Name (5)Mitz Braddock Tyre Fnp

Secondary Practice Location 1

Location 15 Executive CirSavannah, GA 31406-3345 · Phone (912) 349-9777

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Mitzi Braddock Tyre Fnp is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID6800065582
PECOS Enrollment IDI20110815000504, I20241010001976
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 2

Services this provider delivered to Medicare fee-for-service patients, from the 2024 & 2026 CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit, 20-29 minutes 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
46 services22 patients
Telehealth originating site facility fee Q3014
The Telehealth originating site facility fee is a charge for the location where you receive your telehealth service, such as a clinic or hospital. It covers costs like equipment use, technical support, and other resources needed to provide a secure, effective telehealth visit.
29 services14 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 31503 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$83.23 typical visit price
range $53.31 – $164.04
Typical copayment $20.80 (range $13.32 – $41.01)
Most-billed visit code 99203
Established Patient
$94.84 typical visit price
range $16.68 – $133.24
Typical copayment $23.71 (range $4.17 – $33.31)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 18

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Psychiatry & Neurology (Psychiatry)
1007 MARY ST
WAYCROSS, GA 31503
Psychiatry & Neurology (Psychiatry)
1007 MARY ST
WAYCROSS, GA 31503
Licensed Practical Nurse
1007 MARY ST
WAYCROSS, GA 31503
Registered Nurse (Addiction (Substance Use Disorder))
1007 MARY ST
WAYCROSS, GA 31503
Licensed Practical Nurse
1007 MARY ST
WAYCROSS, GA 31503
Registered Nurse (Addiction (Substance Use Disorder))
1007 MARY ST
WAYCROSS, GA 31503
Licensed Practical Nurse
1007 MARY ST
WAYCROSS, GA 31503
Licensed Practical Nurse
1007 MARY ST
WAYCROSS, GA 31503

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1396983227, enumerated as an "individual" on January 30, 2009.

The provider is located at 1007 MARY ST WAYCROSS, GA 31503 and the phone number is (912) 387-7737.

Nurse Practitioner with taxonomy code 363LP0808X and a focus in Psychiatric/Mental Health.

The provider might be accepting Accepts: Alliant Health Plans, Inc., Ambetter from Absolute. Please consult your insurance carrier or call the provider to verify.