| CASE NUMBER | I-200-24193-189147 |
| CASE STATUS | Certified |
| RECEIVED DATE | 7/11/2024 |
| DECISION DATE | 7/18/2024 |
| ORIGINAL CERT DATE | |
| VISA CLASS | H-1B |
| JOB TITLE | Physician - Pediatrics |
| SOC CODE | 29-1221.00 |
| SOC TITLE | Pediatricians, General |
| FULL TIME POSITION | Y |
| BEGIN DATE | 10/1/2024 |
| END DATE | 8/9/2027 |
| TOTAL WORKER POSITIONS | 1 |
| NEW EMPLOYMENT | 0 |
| CONTINUED EMPLOYMENT | 0 |
| CHANGE PREVIOUS EMPLOYMENT | 0 |
| NEW CONCURRENT EMPLOYMENT | 0 |
| CHANGE EMPLOYER | 1 |
| AMENDED PETITION | 0 |
| EMPLOYER NAME | Monument Health Rapid City Hospital, Inc. |
| TRADE NAME DBA | Monument Health Rapid City Hospital |
| EMPLOYER ADDRESS1 | 353 Fairmont Boulevard |
| EMPLOYER ADDRESS2 | |
| EMPLOYER CITY | Rapid City |
| EMPLOYER STATE | SD |
| EMPLOYER POSTAL CODE | 57701 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PROVINCE | |
| EMPLOYER PHONE | +16057191000 |
| EMPLOYER PHONE EXT | |
| NAICS CODE | 622110 |
| EMPLOYER POC LAST NAME | Silver |
| EMPLOYER POC FIRST NAME | Kayla |
| EMPLOYER POC MIDDLE NAME | |
| EMPLOYER POC JOB TITLE | Manager, Provider Relations |
| EMPLOYER POC ADDRESS1 | 2925 Regional Way |
| EMPLOYER POC ADDRESS2 | |
| EMPLOYER POC CITY | Rapid City |
| EMPLOYER POC STATE | SD |
| EMPLOYER POC POSTAL CODE | 57709 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PROVINCE | |
| EMPLOYER POC PHONE | +16057559056 |
| EMPLOYER POC PHONE EXT | |
| EMPLOYER POC EMAIL | ksilver@monument.health |
| AGENT REPRESENTING EMPLOYER | Yes |
| AGENT ATTORNEY LAST NAME | Carlson |
| AGENT ATTORNEY FIRST NAME | Beth |
| AGENT ATTORNEY MIDDLE NAME | E. |
| AGENT ATTORNEY ADDRESS1 | 90 S 7th St |
| AGENT ATTORNEY ADDRESS2 | STE 2200 |
| AGENT ATTORNEY CITY | Minneapolis |
| AGENT ATTORNEY STATE | MN |
| AGENT ATTORNEY POSTAL CODE | 55402 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PROVINCE | |
| AGENT ATTORNEY PHONE | +16127667652 |
| AGENT ATTORNEY PHONE EXT | |
| AGENT ATTORNEY EMAIL ADDRESS | beth.carlson@faegredrinker.com |
| LAWFIRM NAME BUSINESS NAME | Faegre Drinker Biddle & Reath LLP |
| STATE OF HIGHEST COURT | MN |
| NAME OF HIGHEST STATE COURT | Minnesota Supreme Court |
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | No |
| SECONDARY ENTITY BUSINESS NAME | |
| WORKSITE ADDRESS1 | 1445 North Avenue |
| WORKSITE ADDRESS2 | |
| WORKSITE CITY | Spearfish |
| WORKSITE COUNTY | LAWRENCE |
| WORKSITE STATE | SD |
| WORKSITE POSTAL CODE | 57783 |
| WAGE RATE OF PAY FROM | 260,000.00 |
| WAGE RATE OF PAY FROM CLEANED | |
| WAGE RATE OF PAY TO | |
| WAGE UNIT OF PAY | Year |
| PREVAILING WAGE | $236,392.00 |
| PW UNIT OF PAY | Year |
| PW TRACKING NUMBER | |
| PW WAGE LEVEL | III |
| PW OES YEAR | 7/1/2024 - 6/30/2025 |
| PW OTHER SOURCE | |
| PW OTHER YEAR | |
| PW SURVEY PUBLISHER | |
| PW SURVEY NAME | |
| TOTAL WORKSITE LOCATIONS | 1 |
| AGREE TO LC STATEMENT | Yes |
| H 1B DEPENDENT | No |
| WILLFUL VIOLATOR | No |
| SUPPORT H1B | N/A |
| STATUTORY BASIS | |
| APPENDIX A ATTACHED | N/A |
| PUBLIC DISCLOSURE | Disclose Business |
| PREPARER LAST NAME | |
| PREPARER FIRST NAME | |
| PREPARER MIDDLE INITIAL | |
| PREPARER BUSINESS NAME | |
| PREPARER EMAIL | |
| BEGIN DATE CONVERTED | 2024-01-10 |
