| CASE NUMBER | I-200-24029-675122 |
| CASE STATUS | Certified |
| RECEIVED DATE | 1/29/2024 |
| DECISION DATE | 2/5/2024 |
| ORIGINAL CERT DATE | |
| VISA CLASS | H-1B |
| JOB TITLE | Gastroenterologist |
| SOC CODE | 29-1216.00 |
| SOC TITLE | General Internal Medicine Physicians |
| FULL TIME POSITION | Y |
| BEGIN DATE | 7/16/2024 |
| END DATE | 7/15/2027 |
| TOTAL WORKER POSITIONS | 1 |
| NEW EMPLOYMENT | 0 |
| CONTINUED EMPLOYMENT | 1 |
| CHANGE PREVIOUS EMPLOYMENT | 0 |
| NEW CONCURRENT EMPLOYMENT | 0 |
| CHANGE EMPLOYER | 0 |
| AMENDED PETITION | 0 |
| EMPLOYER NAME | CONWAY HOSPITAL, INC. |
| TRADE NAME DBA | CONWAY MEDICAL CENTER |
| EMPLOYER ADDRESS1 | 300 SINGLETON RIDGE ROAD |
| EMPLOYER ADDRESS2 | |
| EMPLOYER CITY | CONWAY |
| EMPLOYER STATE | SC |
| EMPLOYER POSTAL CODE | 29526 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PROVINCE | |
| EMPLOYER PHONE | 18432345139 |
| EMPLOYER PHONE EXT | |
| NAICS CODE | 621111 |
| EMPLOYER POC LAST NAME | DANNELLY |
| EMPLOYER POC FIRST NAME | TRAVIS |
| EMPLOYER POC MIDDLE NAME | R. |
| EMPLOYER POC JOB TITLE | PHYSICIAN LIAISON AND RECRUITER |
| EMPLOYER POC ADDRESS1 | 300 SINGLETON RIDGE ROAD |
| EMPLOYER POC ADDRESS2 | |
| EMPLOYER POC CITY | CONWAY |
| EMPLOYER POC STATE | SC |
| EMPLOYER POC POSTAL CODE | 29526 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PROVINCE | |
| EMPLOYER POC PHONE | 18432348611 |
| EMPLOYER POC PHONE EXT | |
| EMPLOYER POC EMAIL | travis.dannelly@cmc-sc.com |
| AGENT REPRESENTING EMPLOYER | Yes |
| AGENT ATTORNEY LAST NAME | Kelly |
| AGENT ATTORNEY FIRST NAME | Dayna |
| AGENT ATTORNEY MIDDLE NAME | Jo |
| AGENT ATTORNEY ADDRESS1 | 101 Two Hills Drive |
| AGENT ATTORNEY ADDRESS2 | Suite 220 |
| AGENT ATTORNEY CITY | Carrboro |
| AGENT ATTORNEY STATE | NC |
| AGENT ATTORNEY POSTAL CODE | 27510 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PROVINCE | |
| AGENT ATTORNEY PHONE | 19199697200 |
| AGENT ATTORNEY PHONE EXT | |
| AGENT ATTORNEY EMAIL ADDRESS | INFO@DKELLY.COM |
| LAWFIRM NAME BUSINESS NAME | Law Offices of Dayna Kelly, PC |
| STATE OF HIGHEST COURT | NC |
| NAME OF HIGHEST STATE COURT | Supreme Court |
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | No |
| SECONDARY ENTITY BUSINESS NAME | |
| WORKSITE ADDRESS1 | 2376 Cypress Circle |
| WORKSITE ADDRESS2 | Suite 203 |
| WORKSITE CITY | Conway |
| WORKSITE COUNTY | HORRY |
| WORKSITE STATE | SC |
| WORKSITE POSTAL CODE | 29526 |
| WAGE RATE OF PAY FROM | 525000 |
| WAGE RATE OF PAY FROM CLEANED | |
| WAGE RATE OF PAY TO | $750,000.00 |
| WAGE UNIT OF PAY | Year |
| PREVAILING WAGE | $181,834.00 |
| PW UNIT OF PAY | Year |
| 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 | 3 |
| 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 | 2025-04-07 |
