Active NPI
Clay Randles, PA-C
- Physician Assistant
- Colorado Springs, CO
National Provider Identifier
1013212943
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA.0005303
- Practice address
- 28 E Willamette Ave
Colorado Springs, CO 80903-1132 - Phone
- (719) 344-9650
- NPI assigned
- Jan 25, 2011
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA16748 | TX | |
| Physician Assistant | 363A00000X | 0010-15518 | NC | |
| Physician Assistant | 363A00000X | 135373 | IA | |
| Physician Assistant | 363A00000X | PA.0005303 | CO | Primary |
| Physician Assistant | 363A00000X | 10257 | AZ |
Addresses
Primary practice location
28 E Willamette Ave
Colorado Springs, CO 80903-1132
Mailing address
28 E Willamette Ave
Colorado Springs, CO 80903-1132
Phone (719) 344-9650
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10257 | AZ | MD | Marriage & Family Therapist |
| PA.0005303 | CO | MD | Physician Assistant |
| 135373 | IA | MD | Physician Assistant |
| 0010-15518 | NC | MD | Physician Assistant |
| PA16748 | TX | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1295913600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1761004800000",
"number": "1013212943",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "28 E WILLAMETTE AVE",
"city": "COLORADO SPRINGS",
"state": "CO",
"postal_code": "809031132",
"telephone_number": "719-344-9650"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "28 E WILLAMETTE AVE",
"city": "COLORADO SPRINGS",
"state": "CO",
"postal_code": "809031132",
"telephone_number": "719-344-9650"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RANDLES",
"first_name": "CLAY",
"name_prefix": "Mr.",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-01-25",
"last_updated": "2025-10-21",
"certification_date": "2025-10-21",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "TX",
"license": "PA16748",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NC",
"license": "0010-15518",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "IA",
"license": "135373",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "CO",
"license": "PA.0005303",
"primary": true
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "AZ",
"license": "10257",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Colorado Springs, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.