NPIMap

Individual provider Active NPI

Kylie Margaret Schuck, PA

  • Physician Assistant
  • Raleigh, NC
National Provider Identifier
1013629872
Registry record updated Jun 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
3200 Blue Ridge Rd Ste 210
Raleigh, NC 27612-8087
Phone
(919) 781-9979
Fax
(919) 781-0124
NPI assigned
Dec 22, 2022
Last updated
Jun 9, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X NU Primary

Addresses

Primary practice location

3200 Blue Ridge Rd Ste 210
Raleigh, NC 27612-8087

Mailing address

1859 Walnut Grove Dr
State College, PA 16801-8442

Other practice location 1

100 Springhall Dr
Goose Creek, SC 29445-5335
Phone (843) 572-8201

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230522000433 SC Practitioner - Physician Assistant 5799141578 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Liberty Doctors LLCGroup PAC ID 0840466017, 44 clinicians
Raleigh Medical Group PAGroup PAC ID 6800874322, 99 clinicians

Practice addresses (Care Compare)

100 Springhall Dr
Goose Creek, SC 29445-5335
Phone (843) 572-8201

110 A Springhall Dr
Goose Creek, SC 29445-5335
Phone (843) 973-8503

110 Springhall Dr
Suite a
Goose Creek, SC 29445-5335
Phone (843) 990-5067

3200 Blue Ridge Rd
Suite 210
Raleigh, NC 27612-8087
Phone (919) 781-9979

418 Folly Rd
Ab
Charleston, SC 29412-2625
Phone (843) 225-8320

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
4764SCMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Raleigh Medical Group, PA CurrentSince Jun 2, 2026 Accepting new patients
Liberty Doctors LLC CurrentSince Apr 10, 2023 Accepting new patients
Liberty Doctors LLC Past Accepting new patients
Raleigh Adult Medicine PA PastSince Jun 2, 2026 Accepting new patients

Locations

3200 Blue Ridge Rd
Ste 210
Raleigh, NC 27612
Phone (919) 781-9979

418 Folly Rd
#A
Charleston, SC 29412
Phone (843) 225-8320

100 Springhall Dr
Goose Creek, SC 29445
Phone (843) 572-8201

Interoperability endpoints

  • Direct secure messaging: kschuck@libertydoctors.ssdirect.aprima.com

Organizations & group practices 4

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

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1671667200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780963200000",
    "number": "1013629872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1859 WALNUT GROVE DR",
            "city": "STATE COLLEGE",
            "state": "PA",
            "postal_code": "168018442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 BLUE RIDGE RD STE 210",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276128087",
            "telephone_number": "919-781-9979",
            "fax_number": "919-781-0124"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 Springhall Dr",
            "address_purpose": "LOCATION",
            "city": "Goose Creek",
            "state": "SC",
            "postal_code": "294455335",
            "country_code": "US",
            "telephone_number": "843-572-8201",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SCHUCK",
        "first_name": "KYLIE",
        "middle_name": "MARGARET",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-12-22",
        "last_updated": "2026-06-09",
        "certification_date": "2026-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

Verify at the official NPI Registry.