Beacon Therapy LLC – Occupational Therapist

Key facts

NPI: 1184559031
Entity type: Organization (NPI type 2)
Primary specialty: Occupational Therapist 225X00000X
Legal business name: BEACON THERAPY LLC
Practice address: 151 N 4TH Ave Ste a
Pocatello, ID 83201-6300
Phone: (208) 604-0800
NPI assigned: Jun 15, 2026
Organization subpart: No

Authorized official

Name: Mr. Gary H Willis II, OT NPI 1710050414
Title: Occupational Therapist
Phone: (208) 604-0800

Authorized official NPPES reports the authorized official by name only; the link goes to the one practitioner connected to this organization with that name.

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Gary Howard Willis II, O.T. Occupational Therapist · Pocatello, ID · NPI 1710050414

NPD Authorized official OCCUPATIONAL THERAPIST

National Provider Directory

Specialties & licenses

Specialty (taxonomy)	Code	Primary
Physical Therapist Group: 193200000X MULTI-SPECIALTY GROUP	225100000X
Occupational Therapist Group: 193200000X MULTI-SPECIALTY GROUP	225X00000X	Yes
Environmental Modification Occupational Therapist Group: 193200000X MULTI-SPECIALTY GROUP	225XE0001X
Ergonomics Occupational Therapist Group: 193200000X MULTI-SPECIALTY GROUP	225XE1200X
Gerontology Occupational Therapist Group: 193200000X MULTI-SPECIALTY GROUP	225XG0600X
Human Factors Occupational Therapist Group: 193200000X MULTI-SPECIALTY GROUP	225XH1300X
Mental Health Occupational Therapist Group: 193200000X MULTI-SPECIALTY GROUP	225XM0800X
Neurorehabilitation Occupational Therapist Group: 193200000X MULTI-SPECIALTY GROUP	225XN1300X
Physical Rehabilitation Occupational Therapist Group: 193200000X MULTI-SPECIALTY GROUP	225XP0019X
Pediatric Occupational Therapist Group: 193200000X MULTI-SPECIALTY GROUP	225XP0200X
Driving and Community Mobility Occupational Therapist Group: 193200000X MULTI-SPECIALTY GROUP	225XR0403X
Speech-Language Pathologist Group: 193200000X MULTI-SPECIALTY GROUP	235Z00000X

Addresses

Primary practice location

151 N 4TH Ave Ste a
Pocatello, ID 83201-6300

Mailing address

1030 Stars Rd
Chubbuck, ID 83202-1982
Phone (208) 604-0800

Other providers in Pocatello, ID

All providers in Pocatello, ID · Occupational Therapist in Idaho

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 15, 2026. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.