Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Keontra Tyes

Individual provider Audiologist · NPI 1134802630

Keontra Tyes is a Qualified Audiologist in Decatur, Georgia. Qualified in 2023, 3 years ago. Practices with Georgia Surgical Professional Services LLC, a 38-clinician group and accepts Medicare assignment. Licensed in Georgia.

Years since qualifying
3
Licensed in
GA
In the registry since
2023

Practice location Address checks out

484 Irvin Ct
Decatur, GA 30030-5406
Phone: (404) 297-4248
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Audiologist (primary) Taxonomy 231H00000X · Licence AUD004381 (GA)

Record details

NPI number1134802630
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedAugust 10, 2023
Last updated in NPPESAugust 10, 2023
Certification dateJune 8, 2023
Mailing address484 Irvin Ct, Decatur, GA 30030-5406

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyQUALIFIED AUDIOLOGIST
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Group practice Georgia Surgical Professional Services Llc — 38 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Decatur