Ladonna L Immken, MD

Primary specialty

Clinical Genetics (M.D.) PhysicianTaxonomy code 207SG0201X

License

G4018 Issued in TX

Practice address

6811 Austin Center Blvd
Suite #400
Austin, TX 78731-3146

Phone

(512) 628-1840

Fax

(512) 628-1840

NPI assigned

May 16, 2006

Last updated

Jan 10, 2012By the provider in NPPES

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

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Dell Children's Medical Group

  • Pediatrics Physician
  • Austin, TX
  • NPI 1326072943

  Clinical Genetics (M.D.)

  Medicare reassignment NPD
• Dell Children's Medical Group

  dba Dell Children's Medical Group Sleep Center

  • Sleep Disorder Diagnostic Clinic/Center
  • Austin, TX
  • NPI 1124748249
  NPD

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

{
    "created_epoch": "1147737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1326153600000",
    "number": "1053363531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 BARBARA JORDAN BLVD STE 200",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787233078",
            "telephone_number": "512-628-1840",
            "fax_number": "512-628-1840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6811 AUSTIN CENTER BLVD",
            "address_2": "SUITE #400",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787313146",
            "telephone_number": "512-628-1840",
            "fax_number": "512-628-1840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IMMKEN",
        "first_name": "LADONNA",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-16",
        "last_updated": "2012-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207SG0201X",
            "taxonomy_group": "",
            "desc": "Medical Genetics, Clinical Genetics (M.D.)",
            "state": "TX",
            "license": "G4018",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "136490301",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "136490305",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Imaging Partners of Austin LLC
• Imaging Partners of Austin LLC
• Erin Imeson, NP
• Shelley L Imholte, PHD
• Mitchell Dongjun Imm, M.D.
• Elizabeth Imouokhome
• Impact Lives LLC
• Impairment Solutions
• Arthur Patrick Imperial, D.D.S., P.C
• Joseph Imsais, M.D.

• Clinical Genetics (M.D.) Physician in Austin, TX
• Providers in Austin, TX by specialty
• Clinical Genetics (M.D.) Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2012; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.