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ADDISON TATE DEBORD
NPI 1548063142
Student in an Organized Health Care Education/Training Program in Monroe, NC

Active since March 29, 2025PECOS Enrolled
1106 REYNOLDS ST STE 100, MONROE, NC 28112(704) 289-5443 Get Directions Write a Review

NPPES record last updated: March 29, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Addison Tate Debord NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ADDISON TATE DEBORD (NPI 1548063142) is an individual student in an organized health care education/training program in Monroe, North Carolina and active in the NPI registry since March 2025. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1548063142
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameADDISON TATE DEBORD
Location Address1106 REYNOLDS ST STE 100Monroe, NC 28112-4376
Mailing Address1106 Reynolds St Ste 100Monroe, NC 28112-4376 · (704) 289-5443
Phone(704) 289-5443
Sole ProprietorNo
Enumeration DateMarch 29, 2025
NPPES CertifiedMarch 29, 2025
✔ NPI 1548063142 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
1106 REYNOLDS ST STE 100, Monroe, NC 28112
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Addison Tate Debord is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 12

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JAKLYN DREW MCCAULEY DO
Student in an Organized Health Care Education/Training Program
1106 REYNOLDS ST STE 100
MONROE, NC 28112
Union County (704) 289-5443
TARA NICOLE COADY
Student in an Organized Health Care Education/Training Program
1106 REYNOLDS ST STE 100
MONROE, NC 28112
Union County (704) 289-5443
MORGAN CARLSON DO
Student in an Organized Health Care Education/Training Program
1106 REYNOLDS ST STE 100
MONROE, NC 28112
Union County (704) 289-5443
MADISON AUDREY DULIS
Student in an Organized Health Care Education/Training Program
1106 REYNOLDS ST STE 100
MONROE, NC 28112
Union County (704) 289-5443
EUI YOUNG KIM MD
Student in an Organized Health Care Education/Training Program
1106 REYNOLDS ST STE 100
MONROE, NC 28112
Union County (704) 289-5443
DR. ALAINA MARIE OLENIK PHARMD, BCACP, CPP
Pharmacist
1106 REYNOLDS ST STE 100
MONROE, NC 28112
Union County (704) 512-7501
ANDREA MARIE SINGLETON
Student in an Organized Health Care Education/Training Program
1106 REYNOLDS ST STE 100
MONROE, NC 28112
Union County (704) 289-5443
ANAYESHA SINGH
Student in an Organized Health Care Education/Training Program
1106 REYNOLDS ST STE 100
MONROE, NC 28112
Union County (704) 289-5443

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Addison Debord's NPI number?

The NPI number for Addison Debord is 1548063142. It was assigned to this individual provider in the NPPES registry on March 29, 2025.

Where is Addison Debord located?

Addison Debord practices at 1106 Reynolds St Ste 100, Monroe, NC 28112. The listed phone number is (704) 289-5443.

What is Addison Debord's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Addison Debord enrolled in Medicare?

Yes. Addison Debord is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Addison Debord was last updated on March 29, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.