Derrill Ernest Schumpert III, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

85972 Issued in SC

Practice address

735 McMillan Road
Clemson, SC 29634-0001

Phone

(864) 656-2233

NPI assigned

Apr 9, 2021

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Trey Schumpert Other name

Medicare fee-for-service enrollment

Enrolled in SC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1617926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723507200000",
    "number": "1225618747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "735 MCMILLAN ROAD",
            "city": "CLEMSON",
            "state": "SC",
            "postal_code": "296340001",
            "telephone_number": "864-656-2233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "735 MCMILLAN ROAD",
            "city": "CLEMSON",
            "state": "SC",
            "postal_code": "296340001",
            "telephone_number": "864-656-2233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHUMPERT",
        "first_name": "DERRILL",
        "middle_name": "ERNEST",
        "name_suffix": "III",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-04-09",
        "last_updated": "2024-08-13",
        "certification_date": "2024-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "85972",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TREY",
            "last_name": "SCHUMPERT",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Jake Edward Rydland
• Corrine Rae Sackett, LMFT
• Henry D. Salter III, M.D.
• Nicholas Richard Saul, BS, MSAT
• SC-Premier Wellness Care
• Martha Kaye Schumpert, DPT
• Kelli Elliott Scott, PHARMD
• Michelle Grant Scott, MSW, LISW-CP
• Jerry F Sherrill, M.D.
• Sena Seats Shirley, NP-C

• Family Medicine Physician in Clemson, SC
• Providers in Clemson, SC by specialty
• Family Medicine Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.