Individual provider Active NPI

Savannah Sutherland Roberson, AGNP

  • Adult Health Nurse Practitioner
  • Washington, NC
National Provider Identifier
1699660035
Registry record updated Jun 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
AG06250013 Issued in NC
Practice address
606 E 12TH St
Washington, NC 27889-3409
Phone
(252) 974-9460
NPI assigned
Jun 9, 2025
Last updated
Jun 9, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X AG06250013 NC Primary
Gerontology Nurse Practitioner 363LG0600X AG06250013 NC

Addresses

Primary practice location

606 E 12TH St
Washington, NC 27889-3409

Mailing address

606 E 12TH St
Washington, NC 27889-3409
Phone (522) 974-9460

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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

Enrollment IDStateProvider typePAC IDDetails
I20250811003432 NC Practitioner - Nurse Practitioner 5890293682 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vidant Medical Group LLCGroup PAC ID 0345343893, 986 clinicians

Practice addresses (Care Compare)

2100 Stantonsburg Rd
Greenville, NC 27834-2818
Phone (252) 847-1757

401 A N Main St
Kenansville, NC 28349-8801
Phone (910) 296-0941

401 N Main St
Kenansville, NC 28349-8801
Phone (910) 296-0941

417 N Main St
Kenansville, NC 28349-8801
Phone (910) 296-8080

606 E 12TH St
Washington, NC 27889-3409
Phone (252) 974-9460

608 E 12TH St
Vidant Multispecialty Clinic Washiington
Washington, NC 27889-3409
Phone (252) 974-7500

628 E 12TH St
Vidant Beaufort Hospitalists
Washington, NC 27889-3409
Phone (252) 975-4178

800 WH Smith Blvd
Greenville, NC 27834-3763

850 WH Smith Blvd
Vidant Cardiology Greenville
Greenville, NC 27834-3763
Phone (252) 758-3211

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
AG06250013NCMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Vidant Medical Group LLC CurrentSince Jul 28, 2025 Accepting new patients

Locations

401 N Main St
Kenansville, NC 28349
Phone (910) 296-0941

606 E 12th St
Washington, NC 27889
Phone (252) 940-6160

Organizations & group practices 1

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1749427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749427200000",
    "number": "1699660035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "606 E 12TH ST",
            "city": "WASHINGTON",
            "state": "NC",
            "postal_code": "278893409",
            "telephone_number": "522-974-9460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "606 E 12TH ST",
            "city": "WASHINGTON",
            "state": "NC",
            "postal_code": "278893409",
            "telephone_number": "252-974-9460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERSON",
        "first_name": "SAVANNAH",
        "middle_name": "SUTHERLAND",
        "credential": "AGNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-06-09",
        "last_updated": "2025-06-09",
        "certification_date": "2025-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NC",
            "license": "AG06250013",
            "primary": true
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "NC",
            "license": "AG06250013",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, NC

Sources for this page

Verify at the official NPI Registry.