Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Beacon Therapy LLC

Organization Physical Therapist · NPI 1184559031

Beacon Therapy LLC is a Physical Therapist in Pocatello, Idaho. Registered with an NPI since 2026.

In the registry since
2026
Specialties on file
12
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

151 N 4th Ave Ste A
Pocatello, ID 83201-6300
Phone: (208) 604-0800
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Occupational Therapist (primary) Taxonomy 225X00000X
Physical Therapist Taxonomy 225100000X
Environmental Modification Occupational Therapist Taxonomy 225XE0001X
Ergonomics Occupational Therapist Taxonomy 225XE1200X
Gerontology Occupational Therapist Taxonomy 225XG0600X
Human Factors Occupational Therapist Taxonomy 225XH1300X
Mental Health Occupational Therapist Taxonomy 225XM0800X
Neurorehabilitation Occupational Therapist Taxonomy 225XN1300X
Physical Rehabilitation Occupational Therapist Taxonomy 225XP0019X
Pediatric Occupational Therapist Taxonomy 225XP0200X
Driving and Community Mobility Occupational Therapist Taxonomy 225XR0403X
Speech-Language Pathologist Taxonomy 235Z00000X

Record details

NPI number1184559031
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Gary Willis — Occupational Therapist · (208) 604-0800
NPI enumeratedJune 15, 2026
Last updated in NPPESJune 15, 2026
Certification dateJune 14, 2026
Mailing address1030 Stars Rd, Chubbuck, ID 83202-1982

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