MEDICARE: BELTON FAMILY PRACTICE CLINIC LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1477500221
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BELTON FAMILY PRACTICE CLINIC LLC

Provider Business Mailing Address
First Line	:	2000 HEALTH PARK DR
Second Line	:
City	:	BRENTWOOD
State	:	TN
Zip	:	37027-4692
Country	:	US
Telephone Number	:	615-373-7406
Fax Number	:

Provider Business Practice Location Address
First Line	:	204 E NORTH AVE
Second Line	:
City	:	BELTON
State	:	MO
Zip	:	64012-2013
Country	:	US
Telephone Number	:	816-331-7744
Fax Number	:

Authorized Official
Title or Position	:	GROUP VICE PRESIDENT
Name	:	BENJAMIN CALKINS
Credential	:
Telephone Number	:	615-372-6536

Provider Enumeration Date	:	05/27/2006
Last Update Date	:	11/21/2025

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