| CASE NUMBER | I-200-24082-823624 |
| CASE STATUS | Certified |
| RECEIVED DATE | 3/22/2024 |
| DECISION DATE | 3/29/2024 |
| ORIGINAL CERT DATE | |
| VISA CLASS | H-1B |
| JOB TITLE | Internal Medicine Physician/Hospitalist |
| SOC CODE | 29-1229.00 |
| SOC TITLE | Physicians, All Other |
| FULL TIME POSITION | Y |
| BEGIN DATE | 9/1/2024 |
| END DATE | 8/31/2027 |
| 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 | North Mississippi Medical Center, Inc. |
| TRADE NAME DBA | |
| EMPLOYER ADDRESS1 | 830 South Gloster |
| EMPLOYER ADDRESS2 | |
| EMPLOYER CITY | Tupelo |
| EMPLOYER STATE | MS |
| EMPLOYER POSTAL CODE | 38801 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PROVINCE | |
| EMPLOYER PHONE | +16623775269 |
| EMPLOYER PHONE EXT | |
| NAICS CODE | 621111 |
| EMPLOYER POC LAST NAME | Feather |
| EMPLOYER POC FIRST NAME | Randall |
| EMPLOYER POC MIDDLE NAME | |
| EMPLOYER POC JOB TITLE | Physician Recruiter |
| EMPLOYER POC ADDRESS1 | 830 South Gloster |
| EMPLOYER POC ADDRESS2 | |
| EMPLOYER POC CITY | Tupelo |
| EMPLOYER POC STATE | MS |
| EMPLOYER POC POSTAL CODE | 38801 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PROVINCE | |
| EMPLOYER POC PHONE | +16623775269 |
| EMPLOYER POC PHONE EXT | |
| EMPLOYER POC EMAIL | rfeather@nmhs.net |
| AGENT REPRESENTING EMPLOYER | Yes |
| AGENT ATTORNEY LAST NAME | Tedrow |
| AGENT ATTORNEY FIRST NAME | Klari |
| AGENT ATTORNEY MIDDLE NAME | B |
| AGENT ATTORNEY ADDRESS1 | 1976 Gadsden Hwy |
| AGENT ATTORNEY ADDRESS2 | Suite # 200 |
| AGENT ATTORNEY CITY | Birmingham |
| AGENT ATTORNEY STATE | AL |
| AGENT ATTORNEY POSTAL CODE | 35235 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PROVINCE | |
| AGENT ATTORNEY PHONE | +12058718084 |
| AGENT ATTORNEY PHONE EXT | |
| AGENT ATTORNEY EMAIL ADDRESS | Daizy@usimmigrant.net |
| LAWFIRM NAME BUSINESS NAME | Klari B. Tedrow, LLC |
| STATE OF HIGHEST COURT | AL |
| NAME OF HIGHEST STATE COURT | SUPREME COURT OF ALABAMA |
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | No |
| SECONDARY ENTITY BUSINESS NAME | |
| WORKSITE ADDRESS1 | 830 South Gloster |
| WORKSITE ADDRESS2 | |
| WORKSITE CITY | Tupelo |
| WORKSITE COUNTY | LEE |
| WORKSITE STATE | MS |
| WORKSITE POSTAL CODE | 38801 |
| WAGE RATE OF PAY FROM | 300000 |
| WAGE RATE OF PAY FROM CLEANED | |
| WAGE RATE OF PAY TO | |
| WAGE UNIT OF PAY | Year |
| PREVAILING WAGE | $239,200.00 |
| PW UNIT OF PAY | Year |
| PW TRACKING NUMBER | |
| PW WAGE LEVEL | N/A |
| 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 | Tedrow |
| PREPARER FIRST NAME | Klari |
| PREPARER MIDDLE INITIAL | B |
| PREPARER BUSINESS NAME | Klari B. Tedrow, LLC |
| PREPARER EMAIL | ktedrow@usimmigrant.net |
| BEGIN DATE CONVERTED | 2024-01-09 |
