Nicollete Gerri Idos

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

2023013961 Issued in MO

Practice address

3443 S National Ave
Springfield, MO 65807-7308

Phone

(417) 269-2000

NPI assigned

May 15, 2023

Sex

Female

Sole proprietor

No

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

Enrolled in MO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2022

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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 and National Provider Directory roles.

• Lester E. Cox Medical Centers

  • Family Medicine Physician
  • Shell Knob, MO
  • NPI 1538334396
  Medicare reassignment
• Lester E Cox Medical Centers

  • Neurology Physician
  • Springfield, MO
  • NPI 1023763414
  NPD
• Lester E Cox Medical Centers

  • Family Medicine Physician
  • Springfield, MO
  • NPI 1467667980
  NPD
• Lester E Cox Medical Centers

  • Family Medicine Physician
  • Willow Springs, MO
  • NPI 1417122326
  NPD (past)
• Lester E. Cox Medical Centers

  • Physical Medicine & Rehabilitation Physician
  • Springfield, MO
  • NPI 1033291125
  NPD (past)

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

{
    "created_epoch": "1684108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756857600000",
    "number": "1831880558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 505673",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631505673",
            "telephone_number": "417-730-6430",
            "fax_number": "417-269-7567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3443 S NATIONAL AVE",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658077308",
            "telephone_number": "417-269-2000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1819 S National Ave",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "MO",
            "postal_code": "658042217",
            "country_code": "US",
            "telephone_number": "417-269-5437",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1000 E Primrose St Ste 300",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "MO",
            "postal_code": "658075178",
            "country_code": "US",
            "telephone_number": "417-269-3700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "IDOS",
        "first_name": "NICOLLETE GERRI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-15",
        "last_updated": "2025-09-03",
        "certification_date": "2025-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MO",
            "license": "2023013961",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ryan Hyde, COTA/L
• Jana D. Hyden, WHNP
• Samantha Josephine Hynes, MAT, LAT, ATC
• Sara Ibbetson, BCBA, LBA
• Shelby Lynn Icenhower, NP-C
• Ashley Ihrig-Opitz, PLPC
• Trecia Ihrig, RN
• John T Ikenroth, CRNA
• Aleksey Illyuk, CRNA
• Imaging Miracles LC

• Physician Assistant in Springfield, MO
• Providers in Springfield, MO by specialty
• Physician Assistant in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.