Active NPI
Shauna Jean Vidaurri, AUD
- Audiologist
- Fort George G. Meade, MD
National Provider Identifier
1396220349
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Audiologist
- License
- 30917
- Practice address
- Usameddac
2480 Llewellyn Avenue
Fort George G. Meade, MD 20755-0001 - Phone
- (503) 333-8959
- NPI assigned
- Sep 26, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Audiologist | 231H00000X | 30917 | OR | Primary |
Addresses
Primary practice location
Usameddac
2480 Llewellyn Avenue
Fort George G. Meade, MD 20755-0001
Mailing address
Usameddac 2480 Llewellyn Ave
Fort George G. Meade, MD 20755
Phone (503) 333-8959
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 |
|---|---|---|---|
| 30917 | OR | MD | Audiologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1537920000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1750032000000",
"number": "1396220349",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "USAMEDDAC 2480 LLEWELLYN AVE",
"city": "FORT GEORGE G. MEADE",
"state": "MD",
"postal_code": "20755",
"telephone_number": "503-333-8959"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "USAMEDDAC",
"address_2": "2480 LLEWELLYN AVENUE",
"city": "FORT GEORGE G. MEADE",
"state": "MD",
"postal_code": "207550001",
"telephone_number": "503-333-8959"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VIDAURRI",
"first_name": "SHAUNA",
"middle_name": "JEAN",
"name_prefix": "Dr.",
"credential": "AUD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-09-26",
"last_updated": "2025-06-16",
"certification_date": "2025-05-29",
"status": "A"
},
"taxonomies": [
{
"code": "231H00000X",
"taxonomy_group": "",
"desc": "Audiologist",
"state": "OR",
"license": "30917",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort George G. Meade, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 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.