Individual provider Active NPI

Olufolake Egbujo, M.D

  • Hematology & Oncology Physician
  • Lynchburg, VA
National Provider Identifier
1366628091
Registry record updated Aug 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
0101282619 Issued in VA
Practice address
1701 Thomson Dr
Lynchburg, VA 24501-1118
Phone
(434) 200-2535
NPI assigned
Jan 11, 2008
Last updated
Aug 21, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Hematology & Oncology Physician 2080P0207X 060032 GA
Hematology & Oncology Physician 207RH0003X 0101282619 VA Primary

Addresses

Primary practice location

1701 Thomson Dr
Lynchburg, VA 24501-1118

Mailing address

1701 Thomson Dr
Lynchburg, VA 24501-1118
Phone (434) 200-4522

Other practice location 1

2015 Uppergate Drive
4th Floor
Atlanta, GA 30322-1062
Phone (404) 785-3240

Other names 1

  • Dr. Olufolake Adisa Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251015001534 VA Practitioner - Hematology/OncologyPractitioner - Pediatric Medicine 7214108208 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hematology/OncologyAlso: Pediatric Medicine
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Centra Medical Group LLCGroup PAC ID 4789606088, 709 clinicians

Practice addresses (Care Compare)

1701 Thomson Dr
Lynchburg, VA 24501-1118
Phone (434) 200-4522

1901 Tate Springs Rd
Lynchburg, VA 24501-1109
Phone (434) 947-3033

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
060032GAMDPediatric Hematology & Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Centra Medical Group, LLC CurrentSince Aug 1, 2025 Accepting new patients

Locations

1701 Thomson Dr
Lynchburg, VA 24501
Phone (434) 200-4010

1701 Thomson Dr
Ste 200
Lynchburg, VA 24501
Phone (434) 200-5925

1901 Tate Springs Rd
Lynchburg, VA 24501
Phone (434) 200-3101

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1200009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755734400000",
    "number": "1366628091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1701 THOMSON DR",
            "city": "LYNCHBURG",
            "state": "VA",
            "postal_code": "245011118",
            "telephone_number": "434-200-4522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 THOMSON DR",
            "city": "LYNCHBURG",
            "state": "VA",
            "postal_code": "245011118",
            "telephone_number": "434-200-2535"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2015 Uppergate Drive",
            "address_2": "4th Floor",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "303221062",
            "country_code": "US",
            "telephone_number": "404-785-3240",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EGBUJO",
        "first_name": "OLUFOLAKE",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-01-11",
        "last_updated": "2025-08-21",
        "certification_date": "2025-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0207X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Hematology-Oncology",
            "state": "GA",
            "license": "060032",
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "VA",
            "license": "0101282619",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "OLUFOLAKE",
            "last_name": "ADISA",
            "prefix": "DR.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Lynchburg, VA

Sources for this page

Verify at the official NPI Registry.