Individual provider Active NPI

Kenneth Armistice Marriott III, M.D.

  • Emergency Medicine Physician
  • San Antonio, TX
National Provider Identifier
1902893183
Registry record updated Oct 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
N8121 Issued in TX
Practice address
4502 Medical Dr
San Antonio, TX 78229-4402
Phone
(210) 358-4000
NPI assigned
Oct 3, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 17, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X N8121 TX Primary
Emergency Medicine Physician 207P00000X 0101236229 VA

Addresses

Primary practice location

4502 Medical Dr
San Antonio, TX 78229-4402

Mailing address

30 Waters Edge Way
San Antonio, TX 78248-1021
Phone (210) 305-3505

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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 1

Enrollment IDStateProvider typePAC IDDetails
I20120130000613 TX Practitioner - Emergency Medicine 2961402284 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Uniformed Services Uhs Fe Hebert School of Med, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emergency Medicine Services of TX, PLLCGroup PAC ID 3375909351, 374 clinicians
Prestige Emergency Consultants LLCGroup PAC ID 5991135386, 11 clinicians

Practice addresses (Care Compare)

20475 Hwy 46 W
Suite 100
Spring Branch, TX 78070-6147
Phone (830) 438-6911

2810 N Loop 1604
Suite 110
San Antonio, TX 78248-2230
Phone (210) 504-4837

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.86 of 100Reported as group
Quality
92.78
Improvement activities
40

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
0101236229VAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Third Coast Emergency Physicians Southwest PA Emergency Medicine CurrentSince Dec 1, 2019 Accepting new patients
Emergency Medicine Services of TX, PLLC Emergency Medicine CurrentSince Apr 1, 2023 Accepting new patients
University of Texas Health Science Center at San Antonio CurrentSince Jul 18, 2017 Accepting new patients
North County Emergency Physicians, LLP Emergency Medicine Past Accepting new patients

Locations

2860 S Gordon St
Alvin, TX 77511
Phone (218) 968-7500

7900 Ranch Road 1826
Austin, TX 78737
Phone (512) 324-5305

504 Medical Center Blvd
Conroe, TX 77304
Phone (936) 539-1111

225 E Parkwood Ave
Friendswood, TX 77546
Phone (281) 549-9400

12285 Bandera Rd
Helotes, TX 78023
Phone (210) 575-2285

1905 E State Highway 97
Jourdanton, TX 78026
Phone (210) 614-9603

100 Medical Pkwy
Lakeway, TX 78738
Phone (512) 206-8100

12412 Judson Rd
Live Oak, TX 78233
Phone (210) 646-5000

1850 State Highway 46 W
Ste 109
New Braunfels, TX 78132
Phone (210) 757-5850

11100 Shadow Creek Pkwy
Pearland, TX 77584
Phone (713) 770-7000

250 E Basse Rd
Ste 101
San Antonio, TX 78209
Phone (210) 638-4159

7700 Floyd Curl Dr
San Antonio, TX 78229
Phone (210) 575-5564

4103 N Loop 1604 W
San Antonio, TX 78249
Phone (210) 572-8415

6700 W Interstate 10
San Antonio, TX 78201
Phone (210) 575-8289

16088 San Pedro Ave
San Antonio, TX 78232
Phone (210) 402-4092

1310 McCullough Ave
San Antonio, TX 78212
Phone (210) 208-2200

13434 Nacogdoches Rd
San Antonio, TX 78217
Phone (210) 447-7560

7703 Floyd Curl Dr
San Antonio, TX 78229
Phone (210) 450-3700

7719 S Ih 35
San Antonio, TX 78224
Phone (210) 572-2955

9211 Potranco Rd
San Antonio, TX 78251
Phone (210) 575-9211

4502 Medical Dr
San Antonio, TX 78229
Phone (210) 358-3555

20475 State Highway 46 W
Ste 100
Spring Branch, TX 78070
Phone (830) 252-5200

26306 Kuykendahl Rd
Tomball, TX 77375
Phone (346) 246-7700

Interoperability endpoints

  • Direct secure messaging: kmarriott66709@direct.utmsa.com

Organizations & group practices 6

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.

Hospital & facility affiliations 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1128297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760659200000",
    "number": "1902893183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 WATERS EDGE WAY",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782481021",
            "telephone_number": "210-305-3505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4502 MEDICAL DR",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782294402",
            "telephone_number": "210-358-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARRIOTT",
        "first_name": "KENNETH",
        "middle_name": "ARMISTICE",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-03",
        "last_updated": "2025-10-17",
        "certification_date": "2025-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "N8121",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "VA",
            "license": "0101236229",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.