Gary Howard Willis II, O.T.

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

OT593 Issued in ID

Practice address

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

Phone

(208) 604-0800

NPI assigned

Nov 17, 2006

Last updated

Jun 14, 2026By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Beacon Therapy LLC

  • Occupational Therapist
  • Pocatello, ID
  • NPI 1184559031
  NPD Authorized official
• Northrup Physical Therapy, PC

  • Physical Therapist
  • Chubbuck, ID
  • NPI 1629146857
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1163721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781395200000",
    "number": "1710050414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1030 STARS RD",
            "city": "CHUBBUCK",
            "state": "ID",
            "postal_code": "832021982",
            "telephone_number": "208-604-0800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "151 N 4TH AVE STE A",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832016300",
            "telephone_number": "208-604-0800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIS",
        "first_name": "GARY",
        "middle_name": "HOWARD",
        "name_suffix": "II",
        "credential": "O.T.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-17",
        "last_updated": "2026-06-14",
        "certification_date": "2026-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "ID",
            "license": "OT593",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marcia Williams, SLP
• Paul Scott Williams, DDS
• Sy Williams, L.C.S.W.
• Matthew E Williamson, D.O.
• Willis Health Care PLLC
• Mark Willis, FNP
• Sara Willis
• Willow Counseling & Consulting LLC (Willow Counseling & Consulting)
• Silas Angier Wills Jr., MD
• Teri Lee Wilske, LSW

• Occupational Therapist in Pocatello, ID
• Providers in Pocatello, ID by specialty
• Occupational Therapist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.