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DR. KELLY PATER HEARN DDS
NPI 1811156748
Dentist - General Practice in Benton Harbor, MI

Active since June 05, 2008Opted out of Medicare · through Aug 26, 2027
1220 E NAPIER AVE, BENTON HARBOR, MI 49022(269) 925-2113(269) 925-2191 Get Directions Write a Review

NPPES record last updated: September 14, 2010. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Dr. Kelly Pater Hearn Dds NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. KELLY PATER HEARN DDS (NPI 1811156748) is an individual general practice provider in Benton Harbor, Michigan, licensed in Michigan (2901019815) and active in the NPI registry since June 2008. She has opted out of Medicare through August 26, 2027.

NPPES Registry Identity

NPI1811156748
Entity TypeIndividualFemale
Primary Taxonomy1223G0001X
Provider Legal NameDR. KELLY PATER HEARNCredential: DDS
Location Address1220 E NAPIER AVEBenton Harbor, MI 49022-3900
Mailing Address1220 E Napier AveBenton Harbor, MI 49022-3900 · (269) 925-2113 · Fax (269) 925-2191
Phone(269) 925-2113
Fax(269) 925-2191
Sole ProprietorNo
Enumeration DateJune 5, 2008
Last NPPES UpdateSeptember 14, 2010
✔ NPI 1811156748 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
License✔ Licensed in MI · 2901019815
Definition
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
1220 E NAPIER AVE, Benton Harbor, MI 49022
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Delta Dental of Michigan, Guardian.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Dr. Kelly Pater Hearn Dds has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from August 26, 2025 through August 26, 2027.

Opt-Out Effective DateAugust 26, 2025
Opt-Out In Effect ThroughAugust 26, 2027Opt-out affidavits renew automatically every two years unless cancelled

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. KAREN N CLISTER DDS PC
Dentist
1220 E NAPIER AVE
BENTON HARBOR, MI 49022
Berrien County (269) 925-2113
DR. KAREN NADINE CLISTER DDS
Dentist
1220 E NAPIER AVE
BENTON HARBOR, MI 49022
Berrien County (269) 925-2113

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kelly Hearn's NPI number?

The NPI number for Kelly Hearn is 1811156748. It was assigned to this individual provider in the NPPES registry on June 5, 2008.

Where is Kelly Hearn located?

Kelly Hearn practices at 1220 E Napier Ave, Benton Harbor, MI 49022. The listed phone number is (269) 925-2113.

What is Kelly Hearn's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

Is Kelly Hearn enrolled in Medicare?

No. Kelly Hearn has opted out of Medicare through August 26, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

What insurance does Kelly Hearn accept?

Health plans from Delta Dental of Michigan and Guardian list Kelly Hearn as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Kelly Hearn was last updated on September 14, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.