Individual provider Active NPI

Laura Jill Tully, MD

  • Otolaryngology Physician
  • Dayton, OH
National Provider Identifier
1871883066
Registry record updated Jan 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
35.132034 Issued in OH
Practice address
1 Childrens PLZ
Dayton, OH 45404-1873
Phone
(937) 641-4000
Fax
(937) 641-4500
NPI assigned
Apr 9, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2026

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X GA
Otolaryngology Physician 207Y00000X Q7611 TX
Otolaryngology Physician 207Y00000X CDR.0005758 CO
Otolaryngology Physician 207Y00000X 35.132034 OH Primary
Otolaryngology Physician 207Y00000X C3349 KY

Addresses

Primary practice location

1 Childrens PLZ
Dayton, OH 45404-1873

Mailing address

PO Box 933432
Cleveland, OH 44193-0039
Phone (937) 641-5072

Other practice location 1

3535 Southern Blvd
Kettering, OH 45429-1221
Phone (937) 641-4000

Other practice location 2

865 W Market St
Troy, OH 45373-3837
Phone (937) 641-4000

Other practice location 3

3333 W Tech Rd
Miamisburg, OH 45342-0955
Phone (937) 641-4000

Other identifiers 1

IdentifierTypeStateIssuer
0237715MedicaidOH

Other names 1

  • Laura Jill White Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ltully130229@direct.owensborohealth.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, KY, CO3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20170825002815 OH Practitioner - Otolaryngology 7517260367 Reassigns benefits to 1 organization
I20250221002378 KY Practitioner - Otolaryngology 7517260367 Reassigns benefits to 1 organization
I20251129000176 CO Practitioner - Otolaryngology 7517260367 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Emory University School of Medicine, 2011
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2695 Rocky Mountain Ave
Suite 150
Loveland, CO 80538-8702

Merit-based Incentive Payment System (MIPS)

Final score
87.12 of 100Reported as group
Quality
84.25
Promoting interoperability
100
Improvement activities
40
Cost
72.81

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
CDR.0005758COMDOtolaryngology Physician
C3349KYMDOtolaryngology Physician
Q7611TXMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dayton Children'S Specialty Physicians, Inc. CurrentSince Feb 1, 2026 Accepting new patients
Owensboro Health Medical Group Inc CurrentSince Feb 23, 2025 Accepting new patients
Poudre Valley Medical Group, LLC CurrentSince Dec 5, 2025 Accepting new patients
Dayton Children'S Specialty Physicians, Inc. CurrentSince Feb 1, 2026 Accepting new patients
Owensboro Health Medical Group, Inc CurrentSince Feb 23, 2025 Accepting new patients
Owensboro Health Medical Group Inc Current Accepting new patients
Poudre Valley Medical Group, LLC CurrentSince Dec 5, 2025 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

4404 Barranca Ln
Castle Rock, CO 80104
Phone (720) 733-5260

1400 E Boulder St
Ste 500
Colorado Springs, CO 80909
Phone (719) 364-6487

1400 E Boulder St
Ste 500EAR
Colorado Springs, CO 80909
Phone (719) 364-4120

2211 Mayfair Dr
Ste 102
Owensboro, KY 42301
Phone (270) 688-1351

1000 Breckenridge St
Ste 303
Owensboro, KY 42303
Phone (270) 685-2392

1 Childrens Plz
Dayton, OH 45404
Phone (937) 641-3600

3535 Southern Blvd
Kettering, OH 45429
Phone (937) 298-1221

967 Bellefontaine Ave
Lima, OH 45804
Phone (419) 224-1330

3333 W Tech Rd
Miamisburg, OH 45342
Phone (937) 641-3400

865 W Market St
Troy, OH 45373
Phone (937) 641-3418

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1302307200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768262400000",
    "number": "1871883066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 933432",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441930039",
            "telephone_number": "937-641-5072",
            "fax_number": "937-641-6129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 CHILDRENS PLZ",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454041873",
            "telephone_number": "937-641-4000",
            "fax_number": "937-641-4500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3535 Southern Blvd",
            "address_purpose": "LOCATION",
            "city": "Kettering",
            "state": "OH",
            "postal_code": "454291221",
            "country_code": "US",
            "telephone_number": "937-641-4000",
            "fax_number": "937-641-4500",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "865 W Market St",
            "address_purpose": "LOCATION",
            "city": "Troy",
            "state": "OH",
            "postal_code": "453733837",
            "country_code": "US",
            "telephone_number": "937-641-4000",
            "fax_number": "937-641-4500",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3333 W Tech Rd",
            "address_purpose": "LOCATION",
            "city": "Miamisburg",
            "state": "OH",
            "postal_code": "453420955",
            "country_code": "US",
            "telephone_number": "937-641-4000",
            "fax_number": "937-641-4500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TULLY",
        "first_name": "LAURA",
        "middle_name": "JILL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-04-09",
        "last_updated": "2026-01-13",
        "certification_date": "2026-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "GA",
            "license": null,
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "TX",
            "license": "Q7611",
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "CO",
            "license": "CDR.0005758",
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "OH",
            "license": "35.132034",
            "primary": true
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "KY",
            "license": "C3349",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0237715",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ltully130229@direct.owensborohealth.org",
            "affiliation": "N",
            "address_1": "1000 Breckenridge St Ste 303",
            "city": "Owensboro",
            "state": "KY",
            "country_code": "US",
            "postal_code": "423030877",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "LAURA",
            "last_name": "WHITE",
            "middle_name": "JILL",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Dayton, OH

Sources for this page

Verify at the official NPI Registry.