Lacy Little Knowles
Family Medicine (Sports Medicine)

Address: 6801 Park Ter Ste 130, Los Angeles, CA 90045
Phone: 3102487878

Lacy Little Knowles (NPI# 1952660599) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider Identifier (NPI) 1952660599
Entity Type Individual
Full Name Lacy Little Knowles
Credential D.O.
Gender Female
Practice Address 6801 Park Ter Ste 130
Los Angeles
CA 90045
Practice Telephone 3102487878
Practice Fax Number 3102487850
Mailing Address Po Box 54679
Los Angeles
CA 90054-0679
Sole Proprietor Yes, this individual is a Sole Proprietor
Enumeration Date 2012-05-15
Last Update Date 2019-12-09

Taxonomy Codes

Primary Taxonomy Classification Taxonomy Group License Number State
No 207QA0505X Family Medicine · Adult Medicine Allopathic & Osteopathic Physicians 20A15521 CA
Yes 207QS0010X Family Medicine · Sports Medicine Allopathic & Osteopathic Physicians 20A15521 CA

Secondary Practice Locations

Address Telephone Number Fax Number
3801 North Blvd, Baton Rouge, LA 708063825 2253877899 2253812579
6801 Park Ter Ste 130, Los Angeles, CA 90045 3102487878 3102487850

Physician Overview

NPI 1952660599
PAC ID by PECOS 4082994595
Professional Enrollment ID I20170803003861
Full Name Lacy Little Knowles
Phone Number 3106557200
Gender F
Graduation Year 2012
Primary Specialty SPORTS MEDICINE
Secondary Specialties FAMILY MEDICINE
Group Practice PAC ID 0941106645
Number of Group Practice Members 602
Accepts Medicare Assignment Y

Claims Based Hospital Affiliation

Claim Control Number (CCN) Legal Business Name

Taxonomy Information

Taxonomy Code 207QS0010X
Grouping Allopathic & Osteopathic Physicians
Classification Family Medicine
Specialization Sports Medicine

Taxonomy Definition

A family medicine physician that is trained to be responsible for continuous care in the field of sports medicine, not only for the enhancement of health and fitness, but also for the prevention of injury and illness. A sports medicine physician must have knowledge and experience in the promotion of wellness and the prevention of injury. Knowledge about special areas of medicine such as exercise physiology, biomechanics, nutrition, psychology, physical rehabilitation, epidemiology, physical evaluation, injuries (treatment and prevention and referral practice) and the role of exercise in promoting a healthy lifestyle are essential to the practice of sports medicine. The sports medicine physician requires special education to provide the knowledge to improve the health care of the individual engaged in physical exercise (sports) whether as an individual or in team participation.
Notes: Source: American Board of Medical Specialties, 2007. [7/1/2007: added definition, added source; 7/1/2011: modified source]
- Additional Resources: American Board of Family Medicine, 2007. American Osteopathic Board of Family Medicine, 2007.
- Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Medicine.

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Office Location

Street Address 6801 PARK TER STE 130
State CA
Zip Code 90045

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Zip Code 90045

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.