Individual provider Active NPI

Tyra M Myers McConkey, OD

  • Optometrist
  • Lawrenceville, GA
National Provider Identifier
1427286301
Registry record updated May 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT002531 Issued in GA
Practice address
725 Walther Rd BLDG 100
Lawrenceville, GA 30046-8725
Phone
(770) 513-3300
Fax
(678) 990-8252
NPI assigned
Jun 30, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 5, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPT002531 GA Primary

Addresses

Primary practice location

725 Walther Rd BLDG 100
Lawrenceville, GA 30046-8725

Mailing address

725 Walther Rd BLDG 100
Lawrenceville, GA 30046-8725
Phone (770) 513-3300

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090824000188 GA Practitioner - Optometry 6901950104 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Forster Eye Care, P.C.Group PAC ID 8628080751, 2 clinicians

Practice addresses (Care Compare)

725 Walther Rd
Suite 100
Lawrenceville, GA 30046-8725
Phone (770) 513-3300

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Forster Eye Care, P.C. Optometrist CurrentSince Sep 29, 2021 Accepting new patients
Dalton Family Eyecare, Inc. Optometrist CurrentSince Jul 16, 2019 Accepting new patients
Reagin Decatur Group, LLC CurrentSince Aug 17, 2018 Accepting new patients
Depoe Eye Center PC Optometrist PastSince Dec 3, 1999 Accepting new patients
Reagin Optometric Group, P.a. Optometrist Past Accepting new patients

Locations

1801 Highway 129 S
Cleveland, GA 30528
Phone (706) 219-4444

134 Ansley Dr
Ste 300
Dahlonega, GA 30533
Phone (706) 219-4444

216 Church St
Decatur, GA 30030
Phone (404) 378-3694

104 Church St
Decatur, GA 30030
Phone (404) 378-3694

725 Walther Rd
#100
Lawrenceville, GA 30046
Phone (770) 513-3300

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1246320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746403200000",
    "number": "1427286301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "725 WALTHER RD BLDG 100",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300468725",
            "telephone_number": "770-513-3300",
            "fax_number": "678-990-8252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 WALTHER RD BLDG 100",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300468725",
            "telephone_number": "770-513-3300",
            "fax_number": "678-990-8252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MYERS MCCONKEY",
        "first_name": "TYRA",
        "middle_name": "M",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-06-30",
        "last_updated": "2025-05-05",
        "certification_date": "2025-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "OPT002531",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrenceville, GA

Sources for this page

Verify at the official NPI Registry.