Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Colton Jason Randall, PA-C

Individual provider Physician Assistant · NPI 1174148696

Colton Jason Randall, PA-C is a Physician Assistant in Twin Falls, Idaho. Qualified in 2020, 6 years ago. Practices with St Lukes Clinic LLC, a 310-clinician group and accepts Medicare assignment. Licensed in Idaho.

Years since qualifying
6
Licensed in
ID
In the registry since
2020
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

775 Pole Line Rd W Ste 112
Twin Falls, ID 83301-5819
Phone: (208) 814-8200
Fax: (208) 933-4921
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA-1928 (ID)

Record details

NPI number1174148696
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedJune 10, 2020
Last updated in NPPESFebruary 9, 2026
Certification dateFebruary 9, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Group practice St Lukes Clinic Llc — 310 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations4 on file with Medicare

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