MEDICARE: FUSION SLEEP MEDICAL LLC

Medicare Provider Information

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

#	Taxonomy Code	Taxonomy
1	2080S0012X	Pediatric Sleep Medicine Physician
2	174400000X	Specialist
3	332B00000X	Durable Medical Equipment & Medical Supplies
4	207Y00000X	Otolaryngology Physician
5	2084S0012X	Sleep Medicine (Psychiatry & Neurology) Physician
6	261QM1300X	Multi-Specialty Clinic/Center
7	207RS0012X	Sleep Medicine (Internal Medicine) Physician
8	207YS0012X	Sleep Medicine (Otolaryngology) Physician
9	261QS1200X	Sleep Disorder Diagnostic Clinic/Center

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	8147	OTHER	GA	MEDICARE

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

NPI Number	:	1467699611
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FUSION SLEEP MEDICAL LLC

Provider Business Mailing Address
First Line	:	100 KIMBALL PL STE 100
Second Line	:
City	:	ALPHARETTA
State	:	GA
Zip	:	30009-2614
Country	:	US
Telephone Number	:	678-990-3962
Fax Number	:	678-623-3862

Provider Business Practice Location Address
First Line	:	3650 MANSELL RD STE 100
Second Line	:
City	:	ALPHARETTA
State	:	GA
Zip	:	30022-3068
Country	:	US
Telephone Number	:	678-990-3962
Fax Number	:	678-623-3862

Authorized Official
Title or Position	:	CEO
Name	:	MR. SIGURJON KRISTJANSSON
Credential	:
Telephone Number	:	678-990-3962

Provider Enumeration Date	:	01/09/2009
Last Update Date	:	02/19/2026