Individual provider Active NPI

Trudy Sheedy, OT

  • Occupational Therapist
  • Boscobel, WI
National Provider Identifier
1497715254
Registry record updated Feb 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
056-001970 Issued in IL
Practice address
205 Parker St
Boscobel, WI 53805-1642
Phone
(608) 375-6311
Fax
(608) 375-6315
NPI assigned
Mar 24, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 056-001970 IL Primary

Addresses

Primary practice location

205 Parker St
Boscobel, WI 53805-1642

Mailing address

205 Parker St
Boscobel, WI 53805-1642
Phone (608) 375-6311

Other names 1

  • Trudy Tinico Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051213000082 IL Practitioner - Occupational Therapist in Private Practice 8123049616 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Synergy Care Southeast LLCGroup PAC ID 6204079163, 193 clinicians

Practice addresses (Care Compare)

117 N Western Ave
Peoria, IL 61604-5650
Phone (309) 674-2400

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
056-001970ILMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Synergy Care Southeast, LLC Occupational Therapist CurrentSince Jan 19, 2026 Accepting new patients

Locations

117 N Western Ave
Peoria, IL 61604
Phone (309) 674-2400

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1143158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771372800000",
    "number": "1497715254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 PARKER ST",
            "city": "BOSCOBEL",
            "state": "WI",
            "postal_code": "538051642",
            "telephone_number": "608-375-6311",
            "fax_number": "608-375-6315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 PARKER ST",
            "city": "BOSCOBEL",
            "state": "WI",
            "postal_code": "538051642",
            "telephone_number": "608-375-6311",
            "fax_number": "608-375-6315"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEEDY",
        "first_name": "TRUDY",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-24",
        "last_updated": "2026-02-18",
        "certification_date": "2026-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IL",
            "license": "056-001970",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TRUDY",
            "last_name": "TINICO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Boscobel, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.