Individual provider Active NPI

Brandon Wallace Godfrey, M.D.

  • Sports Medicine (Emergency Medicine) Physician
  • Yakima, WA
National Provider Identifier
1629495833
Registry record updated Apr 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Emergency Medicine) PhysicianTaxonomy code 207PS0010X
License
61518892 Issued in WA
Practice address
2811 Tieton Dr
Yakima, WA 98902-3761
Phone
(509) 575-8000
NPI assigned
Mar 25, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 61518892 WA
Emergency Medicine Physician 207P00000X 23560 NV
Sports Medicine (Emergency Medicine) Physician 207PS0010X 61518892 WA Primary
Emergency Medicine Physician 207P00000X 51008 AZ

Addresses

Primary practice location

2811 Tieton Dr
Yakima, WA 98902-3761

Mailing address

111 S 11TH Ave Ste 320
Yakima, WA 98902-3273
Phone (509) 454-8888

Other practice location 1

111 S 11th Ave Ste 320
Yakima, WA 98902-3273
Phone (509) 454-8888

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, NV, WA3 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20160916000519 TX Practitioner - Emergency Medicine 8325267008 Reassigns benefits to 1 organization
I20230807003460 NV Practitioner - Emergency Medicine 8325267008 Reassigns benefits to 2 organizations
I20240531001744 WA Practitioner - Emergency Medicine 8325267008 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of Nevada School of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Yakima Valley Memorial PhysiciansGroup PAC ID 1557391596, 397 clinicians

Practice addresses (Care Compare)

2811 Tieton Dr
Yakima, WA 98902-3761
Phone (509) 575-8000

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
51008AZMDEmergency Medicine Physician
23560NVMDEmergency Medicine Physician
61518892WAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sound Physicians Emergency Medicine of Arizona, Inc. Emergency Medicine CurrentSince Jun 1, 2022 Accepting new patients
Northwest HBP Medical Services LLC Emergency Medicine CurrentSince Jul 19, 2023 Accepting new patients
Kittitas County Public Hospital Dist 1 CurrentSince Apr 17, 2024 Accepting new patients
Fremont Emergency Services Scherr LTD Emergency Medicine CurrentSince Aug 1, 2023 Accepting new patients
Fremont Emergency Services Scherr LTD Emergency Medicine Current Accepting new patients
Yakima Valley Memorial Physicians CurrentSince Jul 15, 2024 Accepting new patients
Ton Sells Hospital CurrentSince Oct 29, 2022 Accepting new patients
Sound Physicians Emergency Medicine of Nevada Bessler PLLC Emergency Medicine CurrentSince Sep 11, 2023 Accepting new patients
Progressive Medical Associates PLLC Emergency Medicine CurrentSince Nov 28, 2022 Accepting new patients
Benson Hospital Corporation CurrentSince Oct 1, 2021 Accepting new patients
Yakima Valley Memorial Physicians CurrentSince Jul 15, 2024 Accepting new patients
Kittitas County Public Hospital Dist 1 CurrentSince Oct 1, 2025 Accepting new patients
Benson Hospital Corporation CurrentSince Oct 1, 2021 Accepting new patients
Kittitas County Public Hosp Dist 1 CurrentSince Apr 17, 2024 Accepting new patients
Ton Sells Hospital Past Accepting new patients
Banner-University Medical Group Emergency Medicine PastSince Jun 1, 2022 Accepting new patients

Locations

450 S Ocotillo St
Benson, AZ 85602
Phone (520) 586-2261

1400 S Dobson Rd
Mesa, AZ 85202
Phone (480) 412-3000

1171 W Target Range Rd
Nogales, AZ 85621
Phone (520) 285-3000

1551 E Tangerine Rd
Oro Valley, AZ 85755
Phone (520) 901-3500

6200 N La Cholla Blvd
Tucson, AZ 85741
Phone (520) 229-2657

1601 W Saint Marys Rd
Tucson, AZ 85745
Phone (520) 622-5833

7900 S J Stock Rd
Tucson, AZ 85746
Phone (520) 295-2550

10146 E Old Vail Rd
Tucson, AZ 85747
Phone (520) 229-2657

350 N Wilmot Rd
Tucson, AZ 85711
Phone (520) 873-3000

9300 W Sunset Rd
Las Vegas, NV 89148
Phone (702) 880-2100

1800 W Charleston Blvd
Las Vegas, NV 89102
Phone (702) 207-8253

10770 Las Vegas Blvd S
Las Vegas, NV 89183
Phone (702) 916-9002

3100 N Tenaya Way
Las Vegas, NV 89128
Phone (702) 225-5025

3325 S Fort Apache Rd
Las Vegas, NV 89117
Phone (702) 962-0500

7207 Aliante Pkwy
North Las Vegas, NV 89084
Phone (702) 962-5100

603 S Chestnut St
Ellensburg, WA 98926
Phone (509) 933-8693

100 E Jackson Ave
Ellensburg, WA 98926
Phone (509) 574-6000

2811 Tieton Dr
Yakima, WA 98902
Phone (509) 249-5210

111 S 11th Ave
Ste 320
Yakima, WA 98902
Phone (509) 248-7184

Organizations & group practices 16

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 16

Hospital & facility affiliations 2

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": "1395705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775952000000",
    "number": "1629495833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 S 11TH AVE STE 320",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989023273",
            "telephone_number": "509-454-8888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2811 TIETON DR",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989023761",
            "telephone_number": "509-575-8000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "111 S 11th Ave Ste 320",
            "address_purpose": "LOCATION",
            "city": "Yakima",
            "state": "WA",
            "postal_code": "989023273",
            "country_code": "US",
            "telephone_number": "509-454-8888",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GODFREY",
        "first_name": "BRANDON",
        "middle_name": "WALLACE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-03-25",
        "last_updated": "2026-04-12",
        "certification_date": "2026-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WA",
            "license": "61518892",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NV",
            "license": "23560",
            "primary": false
        },
        {
            "code": "207PS0010X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Sports Medicine",
            "state": "WA",
            "license": "61518892",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "AZ",
            "license": "51008",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yakima, WA

Sources for this page

Verify at the official NPI Registry.