Malik Broady

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

Practice address

7011 Campus Dr Ste 205
Colorado Springs, CO 80920-3104

Phone

(719) 466-4809

NPI assigned

Apr 22, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1619049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619049600000",
    "number": "1447832167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7011 CAMPUS DR STE 205",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809203104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7011 CAMPUS DR STE 205",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809203104",
            "telephone_number": "719-466-4809"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROADY",
        "first_name": "MALIK",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-04-22",
        "last_updated": "2021-04-22",
        "certification_date": "2021-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "malik.broady@coloradobehavior.com",
            "affiliation": "N",
            "endpointDescription": "Provider email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Direct provider email for health information",
            "address_1": "7011 Campus Dr Ste 205",
            "city": "Colorado Springs",
            "state": "CO",
            "country_code": "US",
            "postal_code": "809203104",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Broadmoor Valley Dental Care, PC
• Broadmoor Valley Dental PLLC
• Broadmoor Valley Dental Services, P.C.
• Broadmoor Valley Wellness Center, Inc.
• Brennan Broadway, AGACNP
• Ashley Brock
• David Brock
• Mikaela Jade Brock
• Peter Andrew Brock, FNP-C
• Samantha De Vel Brock, DPT

• Behavior Technician in Colorado Springs, CO
• Providers in Colorado Springs, CO by specialty
• Behavior Technician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.