TIMOTHY KORM (PMHNP-BC) – Psychiatric/Mental Health Nurse Practitioner, NPI 1447717657
Psychiatric/Mental Health Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
3,379 NURSE PRACTITIONER in OR
Provider Addresses for TIMOTHY KORM (PMHNP-BC)
1281 9TH AVE UNIT 2304
SAN DIEGO, CA 921014668
Phone:
Type: Mailing
207 N FIR ST
FL 2
SISTERS, OR 97759
Phone: (978) 328-3023
Type: Mailing
San Diego County Psychiatric Hospital, 3853, Rosecrans Street, Old Town, San Diego, San Diego County, California, 92110, United States
SAN DIEGO, CA 92110
Phone: (619) 692-8200
Type: Location
3853 Rosecrans St
San Diego, CA 92110
Phone: (619) 692-8200
Type: Location
13 Smith Ave
Lowell, MA 018511828
Phone: (978) 328-3023
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2025-11-24
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20251124000748 | I | Nurse Practitioner | OR | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 92101)
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