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

Cooper Vaughn Tietz, DPT

Individual provider Physical Therapist · NPI 1821873795

Cooper Vaughn Tietz, DPT is a Physical Therapist in Private Practice in Detroit Lakes, Minnesota. Qualified in 2023, 3 years ago. Practices with Sanford Medical Center Fargo, a 1,212-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Minnesota.

Years since qualifying
3
Licensed in
MN
In the registry since
2023
What do these letters mean?
DPT — Doctor of Physical Therapy
The doctoral degree now required to enter physical therapy practice.

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Practice location Address checks out

1245 Washington Ave
Detroit Lakes, MN 56501-3905
Phone: (218) 846-2000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 9285 Medical Plaza Dr, Charleston, SC 29406-9126 — (843) 797-8282

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence 13278 (MN)

Record details

NPI number1821873795
Entity typeIndividual (Type 1)
GenderMale
Credentials DPT
Sole proprietorYes
NPI enumeratedAugust 29, 2023
Last updated in NPPESSeptember 5, 2024
Certification dateSeptember 5, 2024

Medicare enrollment

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

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Group practice Sanford Medical Center Fargo — 1212 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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