Individual provider Active NPI

Talicia Durham, NP

  • Nurse Practitioner
  • Daniel Island, SC
National Provider Identifier
1174476022
Registry record updated Feb 19, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
31334 Issued in SC
Practice address
115 Fairchild St Ste 340
Daniel Island, SC 29492-7602
Phone
(888) 562-5442
NPI assigned
Feb 19, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 31334 SC Primary

Addresses

Primary practice location

115 Fairchild St Ste 340
Daniel Island, SC 29492-7602

Mailing address

200 Oceangate Ste 100
Long Beach, CA 90802-4317
Phone (888) 562-5442

Medicare participation

Medicare enrollment files
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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260227002646 SC Practitioner - Nurse Practitioner 8820579774 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1 Brushwood CT
Columbia, SC 29229-9254

200 Oceangate
Suite 100
Long Beach, CA 90802-4316

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
31334SCMDNurse Practitioner

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": "1771459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771459200000",
    "number": "1174476022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 OCEANGATE STE 100",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908024317",
            "telephone_number": "888-562-5442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 FAIRCHILD ST STE 340",
            "city": "DANIEL ISLAND",
            "state": "SC",
            "postal_code": "294927602",
            "telephone_number": "888-562-5442"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DURHAM",
        "first_name": "TALICIA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-02-19",
        "last_updated": "2026-02-19",
        "certification_date": "2026-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "SC",
            "license": "31334",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Daniel Island, SC

Sources for this page

Verify at the official NPI Registry.