Elite Crowning Glory LLC

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

Legal business name

ELITE CROWNING GLORY LLC

Practice address

413 N 5TH St
Jesup, GA 31545-1024

Phone

(912) 630-7678

NPI assigned

Sep 25, 2026

Last updated

Sep 25, 2026By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Angela Darden-Rivers

Title

Ceo/Owner

Phone

(912) 630-7678

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1790294400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1790294400000",
    "number": "1669385100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1425 E OGLETHORPE HWY # 1002",
            "city": "HINESVILLE",
            "state": "GA",
            "postal_code": "313131219",
            "telephone_number": "912-630-7678"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "413 N 5TH ST",
            "city": "JESUP",
            "state": "GA",
            "postal_code": "315451024",
            "telephone_number": "912-630-7678"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELITE CROWNING GLORY  LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-09-25",
        "last_updated": "2026-09-25",
        "certification_date": "2026-09-23",
        "status": "A",
        "authorized_official_last_name": "DARDEN-RIVERS",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_title_or_position": "CEO/OWNER",
        "authorized_official_telephone_number": "912-630-7678",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Prosthetic/Orthotic Supplier in Jesup, GA
• Providers in Jesup, GA by specialty
• Prosthetic/Orthotic Supplier in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 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.

Verify at the official NPI Registry.