MEDICARE: OASIS MENTAL WELLNESS, PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant

General Provider Information

NPI Number	:	1093595969
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OASIS MENTAL WELLNESS, PLLC

Provider Business Mailing Address
First Line	:	300 S MAIN ST STE 212
Second Line	:
City	:	HOLLY SPRINGS
State	:	NC
Zip	:	27540-4201
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	128 RALEIGH ST
Second Line	:
City	:	HOLLY SPRINGS
State	:	NC
Zip	:	27540-9043
Country	:	US
Telephone Number	:	919-704-7324
Fax Number	:	919-626-9524

Authorized Official
Title or Position	:	OWNER AND PHYSICIAN ASSOCIATE
Name	:	LYDIA KYMBERLIE SPARKS RAMOS
Credential	:
Telephone Number	:	919-704-7324

Provider Enumeration Date	:	09/29/2023
Last Update Date	:	10/29/2025

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