Healthcare Provider Details

I. General information

NPI: 1275408148
Provider Name (Legal Business Name): CHESAPEAKE REGIONAL ANESTHESIA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/09/2025
Last Update Date: 10/09/2025
Certification Date: 10/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

736 BATTLEFIELD BLVD N
CHESAPEAKE VA
23320-4941
US

IV. Provider business mailing address

736 BATTLEFIELD BLVD N
CHESAPEAKE VA
23320-4941
US

V. Phone/Fax

Practice location:
  • Phone: 757-312-8121
  • Fax:
Mailing address:
  • Phone: 757-312-8121
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State

VIII. Authorized Official

Name: JAMES REESE JACKSON
Title or Position: PRESIDENT/CEO
Credential:
Phone: 757-312-6171