CCRC of Tiffin, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

CCRC OF TIFFIN, LLC

Doing business as

Clear Creek Village

Practice address

900 Village Drive
Tiffin, IA 52340

Phone

(913) 890-4780

NPI assigned

Apr 14, 2026

Last updated

Apr 14, 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

Jordan R Anderson

Title

Manager of the LLC

Phone

(913) 890-4780

Specialties & licenses 1

Addresses

Other names 1

• Clear Creek Village Doing business as

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

{
    "created_epoch": "1776124800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1776124800000",
    "number": "1417890336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6731 W 121ST ST STE 100",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662092003",
            "telephone_number": "913-890-4780",
            "fax_number": "913-956-6564"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 VILLAGE DRIVE",
            "city": "TIFFIN",
            "state": "IA",
            "postal_code": "52340",
            "telephone_number": "913-890-4780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CCRC OF TIFFIN, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-04-14",
        "last_updated": "2026-04-14",
        "certification_date": "2026-04-07",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "JORDAN",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "MANAGER OF THE LLC",
        "authorized_official_telephone_number": "913-890-4780"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Clear Creek Village",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Amana Society (Tiffin Pharmacy)
• Jordan Matthew Barrera, PT, DPT
• Andrew Beckler
• Gabi B Bulbula
• Jon Burzacott
• Samantha Chyko
• Angela Marie Dunn, D.C.
• Jodeen Francis, ADULT ARNP
• Daniel Phillip Goldsmith, DDS
• Keilyn Michelle Hahn

• Skilled Nursing Facility in Tiffin, IA
• Providers in Tiffin, IA by specialty
• Skilled Nursing Facility in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 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.