Jaclyn Benthall Shipley, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

224595 Issued in NC

Practice address

Department of Anesthesiology N2198 Unc
CB# 7010
Chapel Hill, NC 27599-7010

Phone

(919) 966-5136

Fax

(984) 974-4873

NPI assigned

Sep 18, 2013

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Watauga Medical Center IncGroup PAC ID 2668377474, 95 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Watauga Medical Center Hospital, Boone, NC, CCN 340051

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Watauga Medical Center, Inc.

  • Hospitalist Physician
  • Boone, NC
  • NPI 1528134194
  Medicare reassignment Care Compare group NPD
• Charles a. Cannon, Jr. Memorial Hospital, Inc

  • Certified Registered Nurse Anesthetist
  • Linville, NC
  • NPI 1346302783

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Chatham Hospital, Inc.

  • Critical Access Hospital
  • Siler City, NC
  • NPI 1689967457
  Medicare reassignment NPD
• Charles a Cannon Jr Memorial Hospital Inc

  • Psychiatric Hospital Unit
  • Linville, NC
  • NPI 1407006968
  NPD
• Charles a. Cannon, Jr. Memorial Hospital, Inc.

  • Cardiovascular Disease Physician
  • Linville, NC
  • NPI 1477006385
  NPD
• Charles a. Cannon, Jr. Memorial Hospital, Inc.

  • Hospitalist Physician
  • Linville, NC
  • NPI 1821403957
  NPD
• Watauga Medical Center Inc

  • Land Ambulance
  • Boone, NC
  • NPI 1255120184
  NPD
• Watauga Medical Center Inc

  • Certified Registered Nurse Anesthetist
  • Boone, NC
  • NPI 1548335581

  Nurse Anesthetist, Certified Registered

  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Watauga Medical Center Inc

  • General Acute Care Hospital
  • Boone, NC
  • NPI 1205859766
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1379462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476057600000",
    "number": "1114353471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 271647",
            "address_2": "UNC FP",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841271647",
            "telephone_number": "919-448-8262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "DEPARTMENT OF ANESTHESIOLOGY N2198 UNC",
            "address_2": "CB# 7010",
            "city": "CHAPEL HILL",
            "state": "NC",
            "postal_code": "275997010",
            "telephone_number": "919-966-5136",
            "fax_number": "984-974-4873"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIPLEY",
        "first_name": "JACLYN",
        "middle_name": "BENTHALL",
        "name_prefix": "Mrs.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-18",
        "last_updated": "2016-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NC",
            "license": "224595",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Frank W Shields IV, MD
• Victoria Lynn Shields, M.DIV., M.ED., LCAS
• Mary Elizabeth Bryant Shilliday, PHARMD
• Yael Shiloh-Malawsky, M.D.
• Shin and Kim, DDS, PLLC
• Anna Shirk
• William W Shockley, MD
• David Gardner Shoemaker, PSY.D.
• Ayumi Shoji, DD, PHD
• Phillip Sholes, M.D.

• Certified Registered Nurse Anesthetist in Chapel Hill, NC
• Providers in Chapel Hill, NC by specialty
• Certified Registered Nurse Anesthetist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.