Fortune Egbulefu, MD

Primary specialty

Adult Reconstructive Orthopaedic Surgery PhysicianTaxonomy code 207XS0114X

License

20444 Issued in NV

Practice address

1060 W Perimeter Rd
JB Andrews, MD 20762-6602

Phone

(888) 999-1212

NPI assigned

Aug 9, 2012

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NV

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: fegbulefu95834@direct.rivhs.com

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.

• Las Vegas Medical Group LLC

  • Internal Medicine Physician
  • Las Vegas, NV
  • NPI 1447656988
  Medicare reassignment NPD

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

{
    "created_epoch": "1344470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787702400000",
    "number": "1497002471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4700 LAS VEGAS BLVD N",
            "city": "NELLIS AFB",
            "state": "NV",
            "postal_code": "891916600",
            "telephone_number": "702-653-3040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1060 W PERIMETER RD",
            "city": "JB ANDREWS",
            "state": "MD",
            "postal_code": "207626602",
            "telephone_number": "888-999-1212"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4700 Las Vegas Blvd N",
            "address_purpose": "LOCATION",
            "city": "Nellis AFB",
            "state": "NV",
            "postal_code": "891916600",
            "country_code": "US",
            "telephone_number": "702-653-3040",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "812 Gorman Ave",
            "address_purpose": "LOCATION",
            "city": "Elkins",
            "state": "WV",
            "postal_code": "262413181",
            "country_code": "US",
            "telephone_number": "304-636-3300",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "230 Hospital Plz",
            "address_purpose": "LOCATION",
            "city": "Weston",
            "state": "WV",
            "postal_code": "264528558",
            "country_code": "US",
            "telephone_number": "304-269-8000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "330 S Lola Ln Ste 200",
            "address_purpose": "LOCATION",
            "city": "Pahrump",
            "state": "NV",
            "postal_code": "890480879",
            "country_code": "US",
            "telephone_number": "775-751-7100",
            "fax_number": "775-751-7824",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "29 Hospital Plz Ste C",
            "address_purpose": "LOCATION",
            "city": "Weston",
            "state": "WV",
            "postal_code": "264528471",
            "country_code": "US",
            "telephone_number": "304-269-4431",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "801 Gorman Ave",
            "address_purpose": "LOCATION",
            "city": "Elkins",
            "state": "WV",
            "postal_code": "262413147",
            "country_code": "US",
            "telephone_number": "304-637-4509",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9300 DeWitt Loop",
            "address_purpose": "LOCATION",
            "city": "Fort Belvoir",
            "state": "VA",
            "postal_code": "220605285",
            "country_code": "US",
            "telephone_number": "571-231-2191",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EGBULEFU",
        "first_name": "FORTUNE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-08-09",
        "last_updated": "2026-08-26",
        "certification_date": "2026-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "WV",
            "license": "36953",
            "primary": false
        },
        {
            "code": "207XS0114X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery",
            "state": "NV",
            "license": "20444",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nathan Joshua Deming, DPT, PHD
• Lisa Midori Dodobara-Griffith, D. O.
• John Doleski, LCSW-C
• Jeremy Theron Drenckhahn, MD
• Tim Dale Duffy, DO
• Rocki Lynn Elam, NP, CNS, RN
• Jordan Michael Ellis, PHD
• Brittany Nichole Estes
• Nalani Farr
• Lauren Ferguson, DO

• Adult Reconstructive Orthopaedic Surgery Physician in JB Andrews, MD
• Providers in JB Andrews, MD by specialty
• Adult Reconstructive Orthopaedic Surgery Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.