Individual provider Active NPI

Matthew Jin Won Stradley, CPHT, RPHT, LPHT

  • Pharmacy Technician
  • Rockville, MD
National Provider Identifier
1225879521
Registry record updated Apr 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pharmacy TechnicianTaxonomy code 183700000X
License
T28692 Issued in MD
Practice address
9715 Medical Center Dr Ste 100
Rockville, MD 20850-6319
Phone
(301) 424-1411
Fax
(301) 424-0232
NPI assigned
Jun 3, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy Technician 183700000X 0230041785 VA
Pharmacy Technician 183700000X PT100004273 DC
Pharmacy Technician 183700000X T28692 MD Primary

Addresses

Primary practice location

9715 Medical Center Dr Ste 100
Rockville, MD 20850-6319

Mailing address

2001 L St NW Ste 500
Washington, DC 20036-4955
Phone (202) 798-0436

Other practice location 1

2001 L St NW Ste 500
Washington, DC 20036-4955
Phone (202) 798-0436

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

State licenses

LicenseStateTypeSpecialty
PT100004273DCMDPharmacy Technician
T28692MDMDPharmacy Technician
0230041785VAMDPharmacy Technician

Practice roles

OrganizationSpecialtyStatusNew patients
Wellrock Pharmacy LLC CurrentSince Nov 8, 2025 Accepting new patients
Wellrock Pharmacy LLC CurrentSince Apr 27, 2025 Accepting new patients

Locations

9715 Medical Center Dr
Ste 100
Rockville, MD 20850
Phone (301) 424-1411

Organizations & group practices 2

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": "1717372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745625600000",
    "number": "1225879521",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 L ST NW STE 500",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200364955",
            "telephone_number": "202-798-0436"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9715 MEDICAL CENTER DR STE 100",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208506319",
            "telephone_number": "301-424-1411",
            "fax_number": "301-424-0232"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2001 L St NW Ste 500",
            "address_purpose": "LOCATION",
            "city": "Washington",
            "state": "DC",
            "postal_code": "200364955",
            "country_code": "US",
            "telephone_number": "202-798-0436",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STRADLEY",
        "first_name": "MATTHEW JIN",
        "middle_name": "WON",
        "credential": "CPHT, RPHT, LPHT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-06-03",
        "last_updated": "2025-04-26",
        "certification_date": "2025-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183700000X",
            "taxonomy_group": "",
            "desc": "Pharmacy Technician",
            "state": "VA",
            "license": "0230041785",
            "primary": false
        },
        {
            "code": "183700000X",
            "taxonomy_group": "",
            "desc": "Pharmacy Technician",
            "state": "DC",
            "license": "PT100004273",
            "primary": false
        },
        {
            "code": "183700000X",
            "taxonomy_group": "",
            "desc": "Pharmacy Technician",
            "state": "MD",
            "license": "T28692",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockville, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.