Mari Charise Knudsen, MD
Individual provider Active NPI Pediatrics Physician · Fargo, ND
NPI 1790282887 · NPPES record last updated Jun 10, 2025
Key facts
- NPI
- 1790282887
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatrics Physician 208000000X
- License
- 18887 (ND)
- Practice address
- 1702 University Dr S
Fargo, ND 58103-4940 - Phone
- (701) 364-3300
- NPI assigned
- Apr 6, 2018
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 8
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in ND, MT
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20221117002321 | ND | Practitioner - Pediatric Medicine | 5799118659 | Reassigns benefits to 1 organization |
| I20250625001073 | MT | Practitioner - Pediatric Medicine | 5799118659 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 99214 | MT | MD | Pediatrics Physician |
| 18887 | ND | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Innovis Health LLC | Current |
Accepting new patients | |
| Kalispell Regional Medical Center, Inc | Current |
Accepting new patients | |
| Innovis Health, LLC | Current | Accepting new patients | |
| Kalispell Regional Medical Center, Inc | Current |
Accepting new patients | |
| Kalispell Regional Medical Center Inc | Current | Accepting new patients | |
| Innovis Health, LLC | Current |
Accepting new patients | |
| Kalispell Regional Medical Center, Inc | Past | Accepting new patients |
Locations
202 Conway Dr
Ste 100
Kalispell, MT 59901
Phone (406) 751-5666
310 Sunnyview Ln
Kalispell, MT 59901
Phone (406) 751-5310
202 Conway Dr
Ste 200
Kalispell, MT 59901
Phone (406) 752-8433
1273 Burns Way
Kalispell, MT 59901
Phone (406) 752-5000
350 Heritage Way
Ste 2100
Kalispell, MT 59901
Phone (406) 257-8992
3000 32nd Ave S
Fargo, ND 58103
Phone (701) 364-3000
1702 University Dr S
Fargo, ND 58103
Phone (701) 364-4222
Interoperability endpoints
- krmcmedicalrecords@krhdirect.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 99214 | MT | |
| Pediatrics Physician | 208000000X | 11405426-1205 | UT | |
| Pediatrics Physician | 208000000X | 18887 | ND | Yes |
Addresses
Primary practice location
1702 University Dr S
Fargo, ND 58103-4940
Mailing address
1702 University Dr S
Fargo, ND 58103-4940
Other practice location 1
202 Conway Dr Ste 200
Kalispell, MT 59901-3153
Phone (406) 758-7490
Other practice location 2
1273 Burns Way
Kalispell, MT 59901-3109
Phone (406) 752-8300
Other names
- Mari Goldade
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | krmcmedicalrecords@krhdirect.org | Direct | Kalispell Regional Medical Center Inc |
Other providers in Fargo, ND
- Kelsey Lian Knodel
- Marie Louise Knodel
- Melissa Ann Knopik
- Nancy Knowlton
- Gabrielle Knowski
- Hannah Knudson
- Kayley Knudson
- Kristen E Knudson
- Louise Knudson
- Benjamin D Knutson
All providers in Fargo, ND · Pediatrics Physician in North Dakota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 10, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.