Active NPI
Supreme Standard Wellness Group Inc
- Peer Specialist
- Baltimore, MD
National Provider Identifier
1356247696
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Peer Specialist
- Legal business name
- SUPREME STANDARD WELLNESS GROUP INC
- Practice address
- 6340 Security Blvd Ste 100
Baltimore, MD 21207-5284 - Phone
- (317) 453-6323
- NPI assigned
- Oct 14, 2026
- Last updated
- Oct 14, 2026
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Ms. Gianina Walker
- Title
- Ceo
- Phone
- (317) 453-6323
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Peer Specialist | 175T00000X | Primary |
Addresses
Primary practice location
6340 Security Blvd Ste 100
Baltimore, MD 21207-5284
Mailing address
6340 Security Blvd Ste 100
Baltimore, MD 21207-5284
Phone (317) 453-6323
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1791936000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1791936000000",
"number": "1356247696",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6340 SECURITY BLVD STE 100",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212075284",
"telephone_number": "317-453-6323",
"fax_number": "317-799-9896"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6340 SECURITY BLVD STE 100",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212075284",
"telephone_number": "317-453-6323"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SUPREME STANDARD WELLNESS GROUP INC",
"organizational_subpart": "NO",
"enumeration_date": "2026-10-14",
"last_updated": "2026-10-14",
"certification_date": "2026-10-14",
"status": "A",
"authorized_official_last_name": "WALKER",
"authorized_official_first_name": "GIANINA",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "317-453-6323",
"authorized_official_name_prefix": "Ms."
},
"taxonomies": [
{
"code": "175T00000X",
"taxonomy_group": "",
"desc": "Peer Specialist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Baltimore, MD
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- Supreme Surgical Associates Inc
- Samir Sur, M.D.
- Tanmay Dipakkumar Sura
- Delwin Suraj
- Maryam Shafiah Suraleigh
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.