Provider Demographics
NPI:1457649188
Name:BELTRAME, BRETT JAMES (PT)
Entity Type:Individual
Prefix:
First Name:BRETT
Middle Name:JAMES
Last Name:BELTRAME
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12728 STATE LINE ROAD
Mailing Address - Street 2:N/A
Mailing Address - City:LEAWOOD
Mailing Address - State:KS
Mailing Address - Zip Code:66209-6620
Mailing Address - Country:US
Mailing Address - Phone:913-888-0014
Mailing Address - Fax:816-941-2520
Practice Address - Street 1:12728 STATE LINE ROAD
Practice Address - Street 2:
Practice Address - City:LEAWOOD
Practice Address - State:KS
Practice Address - Zip Code:66209
Practice Address - Country:US
Practice Address - Phone:913-888-0014
Practice Address - Fax:816-941-2520
Is Sole Proprietor?:No
Enumeration Date:2011-07-15
Last Update Date:2019-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1104890225100000X
KS11-04890225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KSKA2868056OtherMEDICARE PTAN
50657015OtherBCBS-KC