LARRY DEAN BLAZIER, RNFA — NPI 1104085265 (Licensed & Credentialed Registered Nurse, Registered Nurse First Assistant in YREKA, CA)

CMS-1500 Box 24J / 33a • NPI

1104085265

Type 1 Individual Rendering/Ordering

HIPAA NUCC Taxonomy • CMS Code

163WR0006X

Licensed & Credentialed Registered Nurse, Registered Nurse First Assistant

Box 32 Service Location & ZIP+4

444 BRUCE ST, YREKA, CA, 96097-3450

✓ 9-Digit EDI 837 ZIP+4 (96097-3450)

Practice Phone & Referral Fax

(530) 842-4121

Direct NPPES Verification Line

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1104085265 (LARRY DEAN BLAZIER, RNFA) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

This practitioner does not currently appear in the CMS individual Order & Referring PECOS file (may practice in pediatrics, commercial-only networks, or hospital-employed settings).

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1104085265` (NPI-1 Individual Practitioner)
Provider / Legal Name	LARRY DEAN BLAZIER, RNFA
Plain-English Specialty	Licensed & Credentialed Registered Nurse, Registered Nurse First Assistant NUCC Code: `163WR0006X` (Registered Nurse, Registered Nurse First Assistant)
Certifying / Licensing Body	State Medical / Healthcare Licensing Board & National Specialty Board
Practice Location Address	444 BRUCE ST, YREKA, CA, 96097-3450
Practice Telephone / Fax	Tel: (530) 842-4121
Administrative Mailing Address	PO BOX 1505, YREKA, CA, 96097-1505
Enumeration & Last Sync	Enumerated: 2008-06-04 \| CMS Record Updated: 2008-06-04

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

444 BRUCE ST, YREKA, CA, 96097-3450

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Plain-English Taxonomy & CMS Crosswalk (163WR0006X)

What Does Taxonomy Code 163WR0006X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 163WR0006X translates to:
"Licensed & Credentialed Registered Nurse, Registered Nurse First Assistant"

CMS-1500 Medicare Specialty Crosswalk: Standard HIPAA X12N 837P / CMS-1500
Certifying / Accrediting Authority: State Medical / Healthcare Licensing Board & National Specialty Board
Clinical Scope: Consult a verified Registered Nurse, Registered Nurse First Assistant for specialized diagnostic evaluation, treatment planning, and continuity of care.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (LARRY DEAN BLAZIER, RNFA)

Typical CPT / Diagnostic Procedures:

Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
Preventive Screening, Patient Counseling & Multidisciplinary Referral

Common Therapeutic Classes:

Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`163WR0006X` — Registered Nurse, Registered Nurse First Assistant Plain English: Licensed & Credentialed Registered Nurse, Registered Nurse First Assistant	State: CA \| License: `534621` \| Primary: Yes (Primary)

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LARRY DEAN BLAZIER, RNFA (NPI #1104085265)