Active NPI
Roy Andrew McKoy II
- Specialist
- Fayetteville, GA
National Provider Identifier
1396640017
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 3250245
- Practice address
- 305 Trilith Pkwy Ste 300
Fayetteville, GA 30214-5565 - Phone
- (855) 643-8643
- NPI assigned
- Oct 12, 2026
- Last updated
- Oct 12, 2026
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 3250245 | GA | Primary |
Addresses
Primary practice location
305 Trilith Pkwy Ste 300
Fayetteville, GA 30214-5565
Mailing address
305 Trilith Pkwy Ste 300
Fayetteville, GA 30214-5565
Phone (855) 643-8643
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1791763200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1791763200000",
"number": "1396640017",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "305 TRILITH PKWY STE 300",
"city": "FAYETTEVILLE",
"state": "GA",
"postal_code": "302145565",
"telephone_number": "855-643-8643"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "305 TRILITH PKWY STE 300",
"city": "FAYETTEVILLE",
"state": "GA",
"postal_code": "302145565",
"telephone_number": "855-643-8643"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCKOY",
"first_name": "ROY",
"middle_name": "ANDREW",
"name_prefix": "Mr.",
"name_suffix": "II",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2026-10-12",
"last_updated": "2026-10-12",
"certification_date": "2026-10-12",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "GA",
"license": "3250245",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Fayetteville, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.