NPIMap

Individual provider Active NPI

Kelli L Iceman, DPM

  • Podiatrist
  • Owatonna, MN
National Provider Identifier
1386008787
Registry record updated Aug 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
1171 Issued in MN
Practice address
225 Cedardale Dr SE
Owatonna, MN 55060-4425
Phone
(507) 288-3443
NPI assigned
Apr 12, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 1171 MN Primary
Podiatrist 213E00000X 1137 WI

Addresses

Primary practice location

225 Cedardale Dr SE
Owatonna, MN 55060-4425

Mailing address

225 Cedardale Dr SE
Owatonna, MN 55060-4425
Phone (507) 288-3443

Other practice location 1

1225 Highway 60 W
Faribault, MN 55021-4964
Phone (507) 334-1951

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240429001402 MN Practitioner - Podiatry 7911294871 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northfield HospitalGroup PAC ID 2567372998, 121 clinicians
Advanced Foot and Ankle Clinic LLCGroup PAC ID 2769497247, 3 clinicians

Practice addresses (Care Compare)

2000 N a Ve
Northfieldm, MN 55057-1498

2000 N Ave
Northfield, MN 55057-1498
Phone (507) 646-1478

4645 Knutsen Dr
Farmington, MN 55024-8455
Phone (651) 460-2300

803 E School St
Owatonna, MN 55060-3112
Phone (507) 451-5950

9974 214TH St W
Lakeville, MN 55044-1913
Phone (952) 469-0500

Hospital & facility affiliations

  • Northfield Hospital Hospital, Northfield, MN, CCN 240014
  • Owatonna Hospital Hospital, Owatonna, MN, CCN 240069

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue75
Removal of skin lesions1-10
Removal of nail tissue209
Removal or shaving of skin growth69
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1137WIMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Northfield Hospital CurrentSince Aug 1, 2024 Accepting new patients
Advanced Foot & Ankle Clinic LLC Podiatrist CurrentSince Mar 17, 2024 Accepting new patients
Northfield Hospital CurrentSince Aug 1, 2024 Accepting new patients
Advanced Foot & Ankle Clinic LLC Podiatrist CurrentSince Mar 17, 2024 Accepting new patients
Northfield Hospital Current Accepting new patients
Brian D. Heeringa PC PastSince Sep 29, 2019 Accepting new patients
Advanced Foot & Ankle Clinic LLC Podiatrist Past Accepting new patients

Locations

1225 Highway 60 W
Faribault, MN 55021
Phone (507) 334-1951

4645 Knutsen Dr
Farmington, MN 55024
Phone (651) 460-2300

2000 North Ave
Northfield, MN 55057
Phone (507) 646-1000

803 E School St
Owatonna, MN 55060
Phone (507) 334-1951

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/26297/brand/1/csg/1/fhir/r4
  • Direct secure messaging: kelli.iceman.1@26297.direct.athenahealth.com

Organizations & group practices 15

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.

View all 15

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1460419200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787616000000",
    "number": "1386008787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 CEDARDALE DR SE",
            "city": "OWATONNA",
            "state": "MN",
            "postal_code": "550604425",
            "telephone_number": "507-288-3443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 CEDARDALE DR SE",
            "city": "OWATONNA",
            "state": "MN",
            "postal_code": "550604425",
            "telephone_number": "507-288-3443"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1225 Highway 60 W",
            "address_purpose": "LOCATION",
            "city": "Faribault",
            "state": "MN",
            "postal_code": "550214964",
            "country_code": "US",
            "telephone_number": "507-334-1951",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ICEMAN",
        "first_name": "KELLI",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-12",
        "last_updated": "2026-08-25",
        "certification_date": "2026-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "MN",
            "license": "1171",
            "primary": true
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "WI",
            "license": "1137",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Owatonna, MN

Sources for this page

Verify at the official NPI Registry.