Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dr. Janine Nicole Pettiford, MD

Individual provider Surgery Physician · NPI 1043541725

Dr. Janine Nicole Pettiford, MD is a General Surgery in Fayetteville, Georgia. Graduated from Saint Louis University School of Medicine in 2005, 21 years ago. Practices with Northside Surgical Professional Services LLC, a 368-clinician group and accepts Medicare assignment. Licensed in Georgia, Missouri and Texas.

Years since qualifying
21
Trained at
Saint Louis University School of Medicine
Licensed in
GA, MO, TX
In the registry since
2010
Specialties on file
3
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

325 N Jeff Davis Dr
Fayetteville, GA 30214
Phone: (770) 461-1337
Fax: (770) 461-0922
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Surgery Physician (primary) Taxonomy 208600000X · Licence 072414 (GA)
Surgery Physician Taxonomy 208600000X · Licence BP10023659 (TX)
Surgery Physician Taxonomy 208600000X · Licence 2010013505 (MO)

Record details

NPI number1043541725
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD
Sole proprietorYes
NPI enumeratedJanuary 20, 2010
Last updated in NPPESNovember 8, 2016

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyGENERAL SURGERY
Medical schoolSAINT LOUIS UNIVERSITY SCHOOL OF MEDICINE
Graduated 2005 (21 years in practice)
Group practice Northside Surgical Professional Services Llc — 368 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations4 on file with Medicare

Other providers in Fayetteville