Individual provider Active NPI

Rodney Antonius McKoy

  • Community Health Worker
  • Winston Salem, NC
National Provider Identifier
1689544827
Registry record updated Nov 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health WorkerTaxonomy code 172V00000X
License
1972478592 Issued in NC
Practice address
3101 Butterfield Dr
Winston Salem, NC 27105-3940
Phone
(336) 986-5896
NPI assigned
Nov 11, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Worker 172V00000X 1972478592 NC Primary
Long Term Care Pharmacy 3336L0003X 1972478592 NC

Addresses

Primary practice location

3101 Butterfield Dr
Winston Salem, NC 27105-3940

Mailing address

3101 Butterfield Dr
Winston Salem, NC 27105-3940
Phone (336) 986-5896

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

State licenses

LicenseStateTypeSpecialty
1972478592NCMDLong Term Care Pharmacy

Practice roles

OrganizationSpecialtyStatusNew patients
I-Cart Home Care Services LLC Community Health Worker CurrentSince Nov 18, 2025 Accepting new patients

Organizations & group practices 1

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": "1762819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762905600000",
    "number": "1689544827",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3101 BUTTERFIELD DR",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271053940",
            "telephone_number": "336-986-5896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3101 BUTTERFIELD DR",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271053940",
            "telephone_number": "336-986-5896"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKOY",
        "first_name": "RODNEY",
        "middle_name": "ANTONIUS",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-11-11",
        "last_updated": "2025-11-12",
        "certification_date": "2025-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": "NC",
            "license": "1972478592",
            "primary": true
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "NC",
            "license": "1972478592",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2025; 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.