MEDICARE: TIMOTHY BUSCH

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	106S00000X	Behavior Technician

General Provider Information

NPI Number	:	1114874013
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TIMOTHY BUSCH

Provider Business Mailing Address
First Line	:	1824 TOUBY PIKE STE B
Second Line	:
City	:	KOKOMO
State	:	IN
Zip	:	46901-2573
Country	:	US
Telephone Number	:	765-628-7400
Fax Number	:

Provider Business Practice Location Address
First Line	:	3234 W SCHIMMER DR
Second Line	:
City	:	GRAND ISLAND
State	:	NE
Zip	:	68801-7316
Country	:	US
Telephone Number	:	574-387-4313
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/11/2026
Last Update Date	:	03/12/2026

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Directions to “ TIMOTHY BUSCH ” Practice Location

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