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

Nicollete Gerri Idos

Individual provider Physician Assistant · NPI 1831880558

Nicollete Gerri Idos is a Physician Assistant in Springfield, Missouri. Qualified in 2022, 4 years ago. Works from 3 locations. Licensed in Missouri.

Years since qualifying
4
Licensed in
MO
In the registry since
2023
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Practice location Address checks out

3443 S National Ave
Springfield, MO 65807-7308
Phone: (417) 269-2000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 1819 S National Ave, Springfield, MO 65804-2217 — (417) 269-5437
  • 1000 E Primrose St Ste 300, Springfield, MO 65807-5178 — (417) 269-3700

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 2023013961 (MO)

Record details

NPI number1831880558
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedMay 15, 2023
Last updated in NPPESSeptember 3, 2025
Certification dateSeptember 3, 2025

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Accepts Medicare assignment Not indicated

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