Active NPI
Marjorie Rose Olgin, OTR
- Occupational Therapist
- Southlake, TX
National Provider Identifier
1083220115
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 126330
- Practice address
- 480 W Southlake Blvd Ste 111
Southlake, TX 76092-6167 - Phone
- (817) 778-9920
- NPI assigned
- Sep 23, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 126330 | TX | Primary |
Addresses
Primary practice location
480 W Southlake Blvd Ste 111
Southlake, TX 76092-6167
Mailing address
2122 York Rd Ste 300
Oak Brook, IL 60523-1925
Phone (630) 575-1980
Other names 1
- Marjorie Campbell
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Occupational Therapist in Private Practice
- Education
- Other, 2025
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
480 W Southlake Blvd
Suite 111
Southlake, TX 76092-6167
Phone (817) 778-9910
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 126330 | TX | MD | Occupational Therapist |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1600819200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1775174400000",
"number": "1083220115",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2122 YORK RD STE 300",
"city": "OAK BROOK",
"state": "IL",
"postal_code": "605231925",
"telephone_number": "630-575-1980"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "480 W SOUTHLAKE BLVD STE 111",
"city": "SOUTHLAKE",
"state": "TX",
"postal_code": "760926167",
"telephone_number": "817-778-9920"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OLGIN",
"first_name": "MARJORIE",
"middle_name": "ROSE",
"credential": "OTR",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-09-23",
"last_updated": "2026-04-03",
"certification_date": "2026-04-03",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Occupational Therapist",
"state": "TX",
"license": "126330",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "MARJORIE",
"last_name": "CAMPBELL",
"credential": "COTA",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Southlake, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.