Active NPI
Sarah Jane Waicus, M.D.
- Student in an Organized Health Care Education/Training Program
- Statesville, NC
National Provider Identifier
1164362174
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- Practice address
- 557 Brookdale Drive
Iredell Health System
Statesville, NC 28677 - Phone
- (704) 878-4973
- Fax
- (704) 878-4568
- NPI assigned
- Mar 30, 2026
- Last updated
- Aug 3, 2026
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | NC | Primary |
Addresses
Primary practice location
557 Brookdale Drive
Iredell Health System
Statesville, NC 28677
Mailing address
124 E Kingston Ave
Apt 1304
Charlotte, NC 28203
Phone (980) 527-4368
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1774828800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1785715200000",
"number": "1164362174",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "124 E KINGSTON AVE",
"address_2": "APT 1304",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "28203",
"telephone_number": "980-527-4368"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "557 BROOKDALE DRIVE",
"address_2": "IREDELL HEALTH SYSTEM",
"city": "STATESVILLE",
"state": "NC",
"postal_code": "28677",
"telephone_number": "704-878-4973",
"fax_number": "704-878-4568"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WAICUS",
"first_name": "SARAH",
"middle_name": "JANE",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2026-03-30",
"last_updated": "2026-08-03",
"certification_date": "2026-08-03",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "NC",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Statesville, NC
- Ethan Vorkink
- Menelaos Voulgaropoulos, M.D.
- Jamila Aisha Wade, M.D.
- Shannon Mayhew Waggoner, FNP-C
- Kenneth Gabriel Wagoner, PTA
- Wake Forest Emergency Providers
- Wake Forest University Baptist Medical Center Community Physicians (Young Family Practice)
- Wake Forest University Health Sciences
- Wal-Mart Stores East LP (Wal-Mart Pharmacy 10-1662)
- Wal-Mart Stores East, LP.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2026; 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.