Provider Demographics
NPI:1164447363
Name:RAINS, SARA TUSSEY (DC)
Entity Type:Individual
Prefix:DR
First Name:SARA
Middle Name:TUSSEY
Last Name:RAINS
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 S STATE ST
Mailing Address - Street 2:SUITE 1
Mailing Address - City:LEXINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:27292-3373
Mailing Address - Country:US
Mailing Address - Phone:336-248-5200
Mailing Address - Fax:336-249-3200
Practice Address - Street 1:200 S STATE ST
Practice Address - Street 2:SUITE 1
Practice Address - City:LEXINGTON
Practice Address - State:NC
Practice Address - Zip Code:27292-3373
Practice Address - Country:US
Practice Address - Phone:336-248-5200
Practice Address - Fax:336-249-3200
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2016-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3391111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5902167Medicaid
NC086CAOtherBLUE CROSS BLUE SHIELD
NC2458463CMedicare PIN