Healthcare Provider Details

I. General information

NPI: 1477421956
Provider Name (Legal Business Name): CHESAPEAKE OBSERVATION MEDICINE SPECIALISTS, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/27/2025
Last Update Date: 10/27/2025
Certification Date: 10/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

736 BATTLEFIELD BLVD N EMERGENCY DEPARTMENT
CHESAPEAKE VA
23320-4906
US

IV. Provider business mailing address

109G GAINSBOROUGH SQ PMB 723
CHESAPEAKE VA
23320-1757
US

V. Phone/Fax

Practice location:
  • Phone: 757-490-9388
  • Fax: 757-490-9401
Mailing address:
  • Phone: 757-490-9388
  • Fax: 757-490-9401

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name: BEN FICKENSCHER
Title or Position: MANAGING PARTNER
Credential: MD
Phone: 757-490-9388