Addison Tate Debord, is a medicare enrolled "Student In An Organized Health Care Education/training Program" physician in Monroe, North Carolina. His current practice location is
1106 Reynolds St Ste 100, Monroe, North Carolina. You can reach out to his office (for appointments etc.) via phone at
(704) 289-5443.
Addison Tate Debord is licensed to practice in * (Not Available) (license number ) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1548063142.
Physician's Profile
| Full Name | Addison Tate Debord |
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| Gender | Male |
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| Speciality | Student In An Organized Health Care Education/training Program |
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| Location | 1106 Reynolds St Ste 100, Monroe, North Carolina |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1548063142
- Provider Enumeration Date: 03/29/2025
- Last Update Date: 09/05/2026
Medicare PECOS Information:
- PECOS PAC ID: 6507363231
- Enrollment ID: I20251008003969
Medical Identifiers
Medical identifiers for Addison Tate Debord such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
| 1548063142 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
| 208D00000X | General Practice | 2026-04160 (North Carolina) | Secondary |
| 390200000X | Student In An Organized Health Care Education/training Program | (* (Not Available)) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Addison Tate Debord is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
Addison Tate Debord, 1106 Reynolds St Ste 100, Monroe, NC 28112-4376 Ph: (704) 289-5443 | Addison Tate Debord, 1106 Reynolds St Ste 100, Monroe, NC 28112-4376 Ph: (704) 289-5443 |
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