Individual provider Active NPI

Katherine Poueymirou Goodpasture, MA, CCC-SLP

  • Speech-Language Pathologist
  • Greensboro, NC
National Provider Identifier
1013289834
Registry record updated Apr 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
8042 Issued in NC
Practice address
5603B W Friendly Ave # 274
Greensboro, NC 27410-4213
Phone
(336) 790-0271
Fax
(336) 740-9099
NPI assigned
Feb 9, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 8042 NC Primary

Addresses

Primary practice location

5603B W Friendly Ave # 274
Greensboro, NC 27410-4213

Mailing address

111 S Tremont Dr
Greensboro, NC 27403-1734
Phone (512) 695-2743

Other practice location 1

714 Green Valley Rd
Greensboro, NC 27408-7018
Phone (336) 370-8100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
8042NCMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1328745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775433600000",
    "number": "1013289834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 S TREMONT DR",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274031734",
            "telephone_number": "512-695-2743"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5603B W FRIENDLY AVE # 274",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274104213",
            "telephone_number": "336-790-0271",
            "fax_number": "336-740-9099"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "714 Green Valley Rd",
            "address_purpose": "LOCATION",
            "city": "Greensboro",
            "state": "NC",
            "postal_code": "274087018",
            "country_code": "US",
            "telephone_number": "336-370-8100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOODPASTURE",
        "first_name": "KATHERINE",
        "middle_name": "POUEYMIROU",
        "credential": "MA, CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-02-09",
        "last_updated": "2026-04-06",
        "certification_date": "2026-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NC",
            "license": "8042",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greensboro, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 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.