Active NPI
Wesley R. Mallicone, MS, ATC
- Athletic Trainer
- Shippensburg, PA
National Provider Identifier
1841287430
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- RT002265A
- Practice address
- 1871 Old Main Dr
Shippensburg, PA 17257-2200 - Phone
- (717) 477-1749
- Fax
- (717) 477-4070
- NPI assigned
- Sep 29, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | RT002265A | PA | Primary |
Addresses
Primary practice location
1871 Old Main Dr
Shippensburg, PA 17257-2200
Mailing address
323 Fort St
Apt.# 6
Shippensburg, PA 17257-1455
Phone (717) 816-3355
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RT002265A | PA | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1127952000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1841287430",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "323 FORT ST",
"address_2": "APT.# 6",
"city": "SHIPPENSBURG",
"state": "PA",
"postal_code": "172571455",
"telephone_number": "717-816-3355"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1871 OLD MAIN DR",
"city": "SHIPPENSBURG",
"state": "PA",
"postal_code": "172572200",
"telephone_number": "717-477-1749",
"fax_number": "717-477-4070"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MALLICONE",
"first_name": "WESLEY",
"middle_name": "R.",
"name_prefix": "Mr.",
"credential": "MS, ATC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-09-29",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "PA",
"license": "RT002265A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Shippensburg, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.