MRS. JACLYN BENTHALL SHIPLEY (CRNA) – Certified Registered Nurse Anesthetist, NPI 1114353471

MRS. JACLYN BENTHALL SHIPLEY (CRNA) is a healthcare provider. based in Salt lake city, Utah. specializing in CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA). They hold the professional credentials CRNA. They hold a License No. 224595 (NC). The NPI Number for MRS. JACLYN BENTHALL SHIPLEY (CRNA) is 1114353471

Main info

Female
13 Years Of Experience
Accepts Medicare Assignment
Name
MRS. JACLYN BENTHALL SHIPLEY (CRNA)
NPI
1114353471
Phone
(919) 448-8262
Address
PO BOX 271647
Enumeration Date
18 September 2013
Last Update Date
10 October 2016

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8282624133
Graduation Year
2013 (13 years ago)
PAC ID
4284861188
Group Practice PAC ID
2668377474
Professional Enrollment ID
I20131223000821
Address ID
NC286075008BO336XXRDXX300
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience38
Completeness75
Years active:12State licenses:1Digital endpointsOther names

3,126 CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA) in NC

Provider Addresses for MRS. JACLYN BENTHALL SHIPLEY (CRNA)

  • PO BOX 271647

    UNC FP

    SALT LAKE CITY, UT 841271647

    Phone: (919) 448-8262

    Type: Mailing

  • DEPARTMENT OF ANESTHESIOLOGY N2198 UNC

    CB# 7010

    CHAPEL HILL, NC 275997010

    Phone: (919) 966-5136

    Fax: (984) 974-4873

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 6 Open Payments records for all available years, with a total value of $123.

Total Amount is formed as General ($123) + Research ($0) + Ownership ($0) = $123.

Last reported payment date: 2024-10-29 • Largest payer in this snapshot: Takeda Pharmaceuticals U.S.A., Inc. ($41).

Total Amount

$123

General + Research + Ownership

Payments

6

Total payment records

General Amount

$123

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-10-29

Latest reported date

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2013-12-23

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20131223000821ICertified Registered Nurse Anesthetist (Crna)NCTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
01402Anesthesia for procedure for total knee joint replacement1111$0
View full utilization report →

Insurance plans in this area (ZIP 84127)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 2668377474View full group profile
NameSpecialtyState
Radiation OncologySC
-NC
Cardiovascular Disease (Cardiology)GA
Certified Registered Nurse Anesthetist (Crna)NC
-NC
Radiation OncologyPA
Family PracticeNC
Nurse PractitionerNC
Certified Registered Nurse Anesthetist (Crna)NC
Certified Registered Nurse Anesthetist (Crna)NC

Reviews

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Frequently asked questions

How do payers reference MRS. JACLYN BENTHALL SHIPLEY (CRNA)?
For MRS. JACLYN BENTHALL SHIPLEY (CRNA), use NPI 1114353471 as the unique 10-digit identifier.
Is there an active status for MRS. JACLYN BENTHALL SHIPLEY (CRNA)?
For scheduling context, MRS. JACLYN BENTHALL SHIPLEY (CRNA) is shown as active in the registry.
What area of care is associated with MRS. JACLYN BENTHALL SHIPLEY (CRNA)?
MRS. JACLYN BENTHALL SHIPLEY (CRNA)'s record emphasizes Certified Registered Nurse Anesthetist. Clinical services aligned with this taxonomy classification.
Is MRS. JACLYN BENTHALL SHIPLEY (CRNA) located near Salt Lake City?
MRS. JACLYN BENTHALL SHIPLEY (CRNA) currently maps to Salt Lake City, Utah in this extract.
Does MRS. JACLYN BENTHALL SHIPLEY (CRNA) accept insurance?
Insurance participation is not part of the core NPI extract — call the plan or office to confirm.

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