Active NPI
Zoe Matson Broadus, BCBA
- Behavior Analyst
- Marquette, MI
National Provider Identifier
1275354896
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 1275354896
- Practice address
- Functional Behavior Services
2353 Badger Street
Marquette, MI 49855-2302 - Phone
- (906) 273-1121
- Fax
- (906) 225-6706
- NPI assigned
- Oct 17, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | 1275354896 | MI | Primary |
Addresses
Primary practice location
Functional Behavior Services
2353 Badger Street
Marquette, MI 49855-2302
Mailing address
2353 Badger Street
Marquette, MI 49855-2302
Phone (906) 273-1121
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1275354896 | MI | MD | Behavioral Analyst |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1729123200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1744070400000",
"number": "1275354896",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2353 BADGER STREET",
"city": "MARQUETTE",
"state": "MI",
"postal_code": "498552302",
"telephone_number": "906-273-1121",
"fax_number": "906-225-6706"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "FUNCTIONAL BEHAVIOR SERVICES",
"address_2": "2353 BADGER STREET",
"city": "MARQUETTE",
"state": "MI",
"postal_code": "498552302",
"telephone_number": "906-273-1121",
"fax_number": "906-225-6706"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BROADUS",
"first_name": "ZOE",
"middle_name": "MATSON",
"name_prefix": "Ms.",
"credential": "BCBA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-10-17",
"last_updated": "2025-04-08",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "MI",
"license": "1275354896",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Marquette, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.