Individual provider Active NPI

Roy Andrew McKoy II

  • Specialist
  • Fayetteville, GA
National Provider Identifier
1396640017
Registry record updated Oct 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
3250245 Issued in GA
Practice address
305 Trilith Pkwy Ste 300
Fayetteville, GA 30214-5565
Phone
(855) 643-8643
NPI assigned
Oct 12, 2026
Last updated
Oct 12, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 12, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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.

Verify at the official NPI Registry.