Provider Demographics
NPI:1114957248
Name:CARTMELL, JO ELLEN (MD)
Entity Type:Individual
Prefix:
First Name:JO ELLEN
Middle Name:
Last Name:CARTMELL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:220 CAMPUS BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:22601-2896
Mailing Address - Country:US
Mailing Address - Phone:540-536-5100
Mailing Address - Fax:703-923-4625
Practice Address - Street 1:333 W CORK ST STE 290
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:VA
Practice Address - Zip Code:22601-3870
Practice Address - Country:US
Practice Address - Phone:540-536-5123
Practice Address - Fax:540-536-3261
Is Sole Proprietor?:No
Enumeration Date:2006-07-04
Last Update Date:2023-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101-040767207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
0412684OtherEVERCARE
1114957248OtherBCBS-VA
609618-01OtherBCBS OF MD
MD(5)Medicaid
0002OtherBCBS-DC
007120S20Medicare PIN
0002OtherBCBS-DC
VA110220624Medicare PIN