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

Mr. Randy C Sidwell, PT, MS, ATC

Individual provider Physical Therapist · NPI 1962547257

Mr. Randy C Sidwell, PT, MS, ATC is a Physical Therapist in Private Practice in Pocatello, Idaho. Qualified in 1996, 30 years ago. Practices with Pocatello Physical Therapy, a 2-clinician group and accepts Medicare assignment. Licensed in Idaho.

Years since qualifying
30
Licensed in
ID
In the registry since
2007
What do these letters mean?
PT — Physical Therapist
A licensed therapist who treats movement, pain and injury.
MS — Master of Science
A graduate science degree.
ATC — Certified Athletic Trainer
Prevents and treats sport and activity injuries.

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Practice location Address checks out

333 N 18th Ave Ste D2
Pocatello, ID 83201-3358
Phone: (208) 232-6490
Fax: (208) 234-4805
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence PT-1535 (ID)

Record details

NPI number1962547257
Entity typeIndividual (Type 1)
GenderMale
Credentials PT , MS , ATC
Sole proprietorNo
NPI enumeratedFebruary 21, 2007
Last updated in NPPESMarch 15, 2012

Medicare enrollment

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

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 1996 (30 years in practice)
Group practice Pocatello Physical Therapy — 2 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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