| CASE NUMBER | I-200-24187-176877 |
| CASE STATUS | Certified |
| RECEIVED DATE | 7/5/2024 |
| DECISION DATE | 7/12/2024 |
| ORIGINAL CERT DATE | |
| VISA CLASS | H-1B |
| JOB TITLE | Hospitalist Physician |
| SOC CODE | 29-1229.02 |
| SOC TITLE | Hospitalists |
| FULL TIME POSITION | Y |
| BEGIN DATE | 8/1/2024 |
| END DATE | 7/31/2027 |
| TOTAL WORKER POSITIONS | 1 |
| NEW EMPLOYMENT | 1 |
| CONTINUED EMPLOYMENT | 0 |
| CHANGE PREVIOUS EMPLOYMENT | 0 |
| NEW CONCURRENT EMPLOYMENT | 0 |
| CHANGE EMPLOYER | 0 |
| AMENDED PETITION | 0 |
| EMPLOYER NAME | Hospital Medicine Services of TN, LLC |
| TRADE NAME DBA | |
| EMPLOYER ADDRESS1 | One Park Plaza |
| EMPLOYER ADDRESS2 | Building I |
| EMPLOYER CITY | Nashville |
| EMPLOYER STATE | TN |
| EMPLOYER POSTAL CODE | 37203 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PROVINCE | |
| EMPLOYER PHONE | +16153449551 |
| EMPLOYER PHONE EXT | |
| NAICS CODE | 621111 |
| EMPLOYER POC LAST NAME | Healy |
| EMPLOYER POC FIRST NAME | Elaine |
| EMPLOYER POC MIDDLE NAME | D. |
| EMPLOYER POC JOB TITLE | Program Administrator US Visa/Expat |
| EMPLOYER POC ADDRESS1 | One Park Plaza |
| EMPLOYER POC ADDRESS2 | Building 1-1E |
| EMPLOYER POC CITY | Nashville |
| EMPLOYER POC STATE | TN |
| EMPLOYER POC POSTAL CODE | 37203 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PROVINCE | |
| EMPLOYER POC PHONE | +16153442292 |
| EMPLOYER POC PHONE EXT | |
| EMPLOYER POC EMAIL | Elaine.Healy@hcahealthcare.com |
| AGENT REPRESENTING EMPLOYER | Yes |
| AGENT ATTORNEY LAST NAME | Katz |
| AGENT ATTORNEY FIRST NAME | Nora |
| AGENT ATTORNEY MIDDLE NAME | |
| AGENT ATTORNEY ADDRESS1 | 511 Union Street |
| AGENT ATTORNEY ADDRESS2 | Suite 2700 |
| AGENT ATTORNEY CITY | Nashville |
| AGENT ATTORNEY STATE | TN |
| AGENT ATTORNEY POSTAL CODE | 37219 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PROVINCE | TENNESSEE |
| AGENT ATTORNEY PHONE | +16158508730 |
| AGENT ATTORNEY PHONE EXT | |
| AGENT ATTORNEY EMAIL ADDRESS | flag@hklaw.com |
| LAWFIRM NAME BUSINESS NAME | Holland & Knight LLP |
| STATE OF HIGHEST COURT | TN |
| NAME OF HIGHEST STATE COURT | Tennessee Supreme Court |
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | No |
| SECONDARY ENTITY BUSINESS NAME | |
| WORKSITE ADDRESS1 | TriStar Centennial Medical Center |
| WORKSITE ADDRESS2 | 2300 Patterson Street |
| WORKSITE CITY | Nashville |
| WORKSITE COUNTY | DAVIDSON |
| WORKSITE STATE | TN |
| WORKSITE POSTAL CODE | 37203 |
| WAGE RATE OF PAY FROM | 100.33 |
| WAGE RATE OF PAY FROM CLEANED | |
| WAGE RATE OF PAY TO | $175.00 |
| WAGE UNIT OF PAY | Hour |
| PREVAILING WAGE | $100.33 |
| PW UNIT OF PAY | Hour |
| PW TRACKING NUMBER | |
| PW WAGE LEVEL | II |
| 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 | Latimer |
| PREPARER FIRST NAME | Hannah |
| PREPARER MIDDLE INITIAL | |
| PREPARER BUSINESS NAME | Holland & Knight, LLP |
| PREPARER EMAIL | hannah.latimer@hklaw.com |
| BEGIN DATE CONVERTED | 2024-01-08 |
