Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days.
Organization
BEACON THERAPY LLC
Active
Organization
BEACON THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GARY H WILLIS II OT (OCCUPATIONAL THERAPIST)
(208) 604-0800
Entity
Organization
Contact information
Practice address
151 N 4TH AVE STE A, POCATELLO, ID 83201-6300
(208) 604-0800
Mailing address
1030 STARS RD, CHUBBUCK, ID 83202-1982
(208) 604-0800
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
—
NULL
225100000X
Physical Therapist
—
—
225X00000X
Occupational Therapist
Primary
—
NULL
225X00000X
Occupational Therapist
Primary
—
—
225XE0001X
Environmental Modification Occupational Therapist
—
NULL
225XE0001X
Environmental Modification Occupational Therapist
—
—
225XE1200X
Ergonomics Occupational Therapist
—
NULL
225XE1200X
Ergonomics Occupational Therapist
—
—
225XG0600X
Gerontology Occupational Therapist
—
NULL
225XG0600X
Gerontology Occupational Therapist
—
—
225XH1300X
Human Factors Occupational Therapist
—
NULL
225XH1300X
Human Factors Occupational Therapist
—
—
225XM0800X
Mental Health Occupational Therapist
—
NULL
225XM0800X
Mental Health Occupational Therapist
—
—
225XN1300X
Neurorehabilitation Occupational Therapist
—
NULL
225XN1300X
Neurorehabilitation Occupational Therapist
—
—
225XP0019X
Physical Rehabilitation Occupational Therapist
—
NULL
225XP0019X
Physical Rehabilitation Occupational Therapist
—
—
225XP0200X
Pediatric Occupational Therapist
—
NULL
225XP0200X
Pediatric Occupational Therapist
—
—
225XR0403X
Driving and Community Mobility Occupational Therapist
—
NULL
225XR0403X
Driving and Community Mobility Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
NULL
235Z00000X
Speech-Language Pathologist
—
—
Other
Enumeration date
06/15/2026
Last updated
06/15/2026
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign upProduct
Developers