| CASE NUMBER | I-200-23338-540692 |
| CASE STATUS | Certified |
| RECEIVED DATE | 12/4/2023 |
| DECISION DATE | 12/11/2023 |
| ORIGINAL CERT DATE | |
| VISA CLASS | H-1B |
| JOB TITLE | Hospitalist Physician |
| SOC CODE | 29-1229.02 |
| SOC TITLE | Hospitalists |
| FULL TIME POSITION | N |
| BEGIN DATE | 1/1/2024 |
| END DATE | 12/31/2026 |
| TOTAL WORKER POSITIONS | 1 |
| NEW EMPLOYMENT | 0 |
| CONTINUED EMPLOYMENT | 0 |
| CHANGE PREVIOUS EMPLOYMENT | 0 |
| NEW CONCURRENT EMPLOYMENT | 0 |
| CHANGE EMPLOYER | 0 |
| AMENDED PETITION | 1 |
| EMPLOYER NAME | LIFESPAN PHYSICIAN GROUP INC. |
| TRADE NAME DBA | |
| EMPLOYER ADDRESS1 | 167 POINT STREET |
| EMPLOYER ADDRESS2 | Suite 2C |
| EMPLOYER CITY | Providence |
| EMPLOYER STATE | RI |
| EMPLOYER POSTAL CODE | 2903 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PROVINCE | |
| EMPLOYER PHONE | 14016062211 |
| EMPLOYER PHONE EXT | |
| NAICS CODE | 621111 |
| EMPLOYER POC LAST NAME | RICHARDS |
| EMPLOYER POC FIRST NAME | PATRICIA |
| EMPLOYER POC MIDDLE NAME | |
| EMPLOYER POC JOB TITLE | VICE PRESIDENT, OPERATIONS |
| EMPLOYER POC ADDRESS1 | 167 Point Street |
| EMPLOYER POC ADDRESS2 | Suite 2C |
| EMPLOYER POC CITY | PROVIDENCE |
| EMPLOYER POC STATE | RI |
| EMPLOYER POC POSTAL CODE | 2903 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PROVINCE | |
| EMPLOYER POC PHONE | 14016062211 |
| EMPLOYER POC PHONE EXT | |
| EMPLOYER POC EMAIL | PRICHARDS@LIFESPAN.ORG |
| AGENT REPRESENTING EMPLOYER | Yes |
| AGENT ATTORNEY LAST NAME | Brown |
| AGENT ATTORNEY FIRST NAME | Thomas |
| AGENT ATTORNEY MIDDLE NAME | STEPHEN |
| AGENT ATTORNEY ADDRESS1 | 2139 BROAD STREET |
| AGENT ATTORNEY ADDRESS2 | |
| AGENT ATTORNEY CITY | CRANSTON |
| AGENT ATTORNEY STATE | RI |
| AGENT ATTORNEY POSTAL CODE | 2905 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PROVINCE | |
| AGENT ATTORNEY PHONE | 14012744040 |
| AGENT ATTORNEY PHONE EXT | |
| AGENT ATTORNEY EMAIL ADDRESS | TBROWN@RODIOBROWN.COM |
| LAWFIRM NAME BUSINESS NAME | Rodio & Brown, Ltd. |
| STATE OF HIGHEST COURT | RI |
| NAME OF HIGHEST STATE COURT | SUPREME COURT |
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | Yes |
| SECONDARY ENTITY BUSINESS NAME | Rhode Island Hospital |
| WORKSITE ADDRESS1 | 593 Eddy Street |
| WORKSITE ADDRESS2 | |
| WORKSITE CITY | Providence |
| WORKSITE COUNTY | PROVIDENCE CITY |
| WORKSITE STATE | RI |
| WORKSITE POSTAL CODE | 2903 |
| WAGE RATE OF PAY FROM | 115.38 |
| WAGE RATE OF PAY FROM CLEANED | |
| WAGE RATE OF PAY TO | |
| WAGE UNIT OF PAY | Hour |
| PREVAILING WAGE | $94.66 |
| PW UNIT OF PAY | Hour |
| PW TRACKING NUMBER | |
| PW WAGE LEVEL | II |
| PW OES YEAR | 7/1/2023 - 6/30/2024 |
| PW OTHER SOURCE | |
| PW OTHER YEAR | |
| PW SURVEY PUBLISHER | |
| PW SURVEY NAME | |
| TOTAL WORKSITE LOCATIONS | 2 |
| 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 | 2024-01-01 |
