| CASE NUMBER | I-200-24176-143529 |
| CASE STATUS | Certified |
| RECEIVED DATE | 6/24/2024 |
| DECISION DATE | 7/1/2024 |
| ORIGINAL CERT DATE | |
| VISA CLASS | H-1B |
| JOB TITLE | Physician - Internal Medicine |
| SOC CODE | 29-1216.00 |
| SOC TITLE | General Internal Medicine Physicians |
| FULL TIME POSITION | Y |
| BEGIN DATE | 9/1/2024 |
| END DATE | 8/31/2027 |
| 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 | Baptist Health Services |
| TRADE NAME DBA | |
| EMPLOYER ADDRESS1 | 9601 Baptist Health Dr |
| EMPLOYER ADDRESS2 | |
| EMPLOYER CITY | Little Rock |
| EMPLOYER STATE | AR |
| EMPLOYER POSTAL CODE | 72205 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PROVINCE | |
| EMPLOYER PHONE | +15018127500 |
| EMPLOYER PHONE EXT | |
| NAICS CODE | 62211 |
| EMPLOYER POC LAST NAME | Rusher |
| EMPLOYER POC FIRST NAME | Will |
| EMPLOYER POC MIDDLE NAME | |
| EMPLOYER POC JOB TITLE | Chief Executive Officer |
| EMPLOYER POC ADDRESS1 | 9601 Baptist Health Dr |
| EMPLOYER POC ADDRESS2 | |
| EMPLOYER POC CITY | Little Rock |
| EMPLOYER POC STATE | AR |
| EMPLOYER POC POSTAL CODE | 72205 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PROVINCE | |
| EMPLOYER POC PHONE | +15018127500 |
| EMPLOYER POC PHONE EXT | |
| EMPLOYER POC EMAIL | wlrusher@practice-plus.com |
| AGENT REPRESENTING EMPLOYER | Yes |
| AGENT ATTORNEY LAST NAME | Borkowski |
| AGENT ATTORNEY FIRST NAME | Misty |
| AGENT ATTORNEY MIDDLE NAME | Wilson |
| AGENT ATTORNEY ADDRESS1 | 200 River Market Ave |
| AGENT ATTORNEY ADDRESS2 | Suite 500 |
| AGENT ATTORNEY CITY | Little Rock |
| AGENT ATTORNEY STATE | AR |
| AGENT ATTORNEY POSTAL CODE | 72201 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PROVINCE | |
| AGENT ATTORNEY PHONE | +15015034479 |
| AGENT ATTORNEY PHONE EXT | |
| AGENT ATTORNEY EMAIL ADDRESS | mborkowski@hallboothsmith.com |
| LAWFIRM NAME BUSINESS NAME | Hall Booth Smith, P.C. |
| STATE OF HIGHEST COURT | AR |
| NAME OF HIGHEST STATE COURT | Supreme |
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | No |
| SECONDARY ENTITY BUSINESS NAME | |
| WORKSITE ADDRESS1 | Baptist Health Renal Care-Fort Smith |
| WORKSITE ADDRESS2 | 1500 Dodson Ave, Suite 280 |
| WORKSITE CITY | Fort Smith |
| WORKSITE COUNTY | SEBASTIAN |
| WORKSITE STATE | AR |
| WORKSITE POSTAL CODE | 72901 |
| WAGE RATE OF PAY FROM | 350,000.00 |
| WAGE RATE OF PAY FROM CLEANED | |
| WAGE RATE OF PAY TO | |
| WAGE UNIT OF PAY | Year |
| PREVAILING WAGE | $334,984.00 |
| PW UNIT OF PAY | Year |
| PW TRACKING NUMBER | |
| PW WAGE LEVEL | IV |
| PW OES YEAR | 7/1/2023 - 6/30/2024 |
| 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 | 2024-01-09 |
