| CASE NUMBER | I-200-25043-687202 |
| CASE STATUS | Certified |
| RECEIVED DATE | 2/12/2025 |
| DECISION DATE | 2/20/2025 |
| ORIGINAL CERT DATE | |
| VISA CLASS | H-1B |
| JOB TITLE | Nephrologist |
| SOC CODE | 29-1229.00 |
| SOC TITLE | Physicians, All Other |
| FULL TIME POSITION | Y |
| BEGIN DATE | 7/1/2025 |
| END DATE | 6/30/2028 |
| 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 | Mercy Clinic Fort Smith Communities |
| TRADE NAME DBA | |
| EMPLOYER ADDRESS1 | 2901 S. 74th St. |
| EMPLOYER ADDRESS2 | |
| EMPLOYER CITY | Fort Smith |
| EMPLOYER STATE | AR |
| EMPLOYER POSTAL CODE | 72903 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PROVINCE | |
| EMPLOYER PHONE | 16185805825 |
| EMPLOYER PHONE EXT | |
| NAICS CODE | 622110 |
| EMPLOYER POC LAST NAME | Martin |
| EMPLOYER POC FIRST NAME | Barb |
| EMPLOYER POC MIDDLE NAME | |
| EMPLOYER POC JOB TITLE | Exec. Director of Ambulatory Care Selection and Onboarding |
| EMPLOYER POC ADDRESS1 | 14528 S. Outer 40 Rd., Suite 100 |
| EMPLOYER POC ADDRESS2 | |
| EMPLOYER POC CITY | Chesterfield |
| EMPLOYER POC STATE | MO |
| EMPLOYER POC POSTAL CODE | 63017 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PROVINCE | |
| EMPLOYER POC PHONE | 16185805825 |
| EMPLOYER POC PHONE EXT | |
| EMPLOYER POC EMAIL | barb.martin@mercy.net |
| AGENT REPRESENTING EMPLOYER | Yes |
| AGENT ATTORNEY LAST NAME | Ozmun |
| AGENT ATTORNEY FIRST NAME | Kristal |
| AGENT ATTORNEY MIDDLE NAME | |
| AGENT ATTORNEY ADDRESS1 | P.O. Box 6435 |
| AGENT ATTORNEY ADDRESS2 | |
| AGENT ATTORNEY CITY | Ithaca |
| AGENT ATTORNEY STATE | NY |
| AGENT ATTORNEY POSTAL CODE | 14851-6435 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PROVINCE | |
| AGENT ATTORNEY PHONE | 16072734200 |
| AGENT ATTORNEY PHONE EXT | |
| AGENT ATTORNEY EMAIL ADDRESS | ko@millermayer.com |
| LAWFIRM NAME BUSINESS NAME | Miller Mayer, LLP |
| STATE OF HIGHEST COURT | NY |
| NAME OF HIGHEST STATE COURT | NY Court of Appeals |
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | No |
| SECONDARY ENTITY BUSINESS NAME | |
| WORKSITE ADDRESS1 | 7301 Rogers Ave. |
| WORKSITE ADDRESS2 | |
| WORKSITE CITY | Fort Smith |
| WORKSITE COUNTY | SEBASTIAN |
| WORKSITE STATE | AR |
| WORKSITE POSTAL CODE | 72903 |
| WAGE RATE OF PAY FROM | $205,379.00 |
| WAGE RATE OF PAY FROM CLEANED | |
| WAGE RATE OF PAY TO | |
| WAGE UNIT OF PAY | Year |
| PREVAILING WAGE | $205,379.00 |
| PW UNIT OF PAY | Year |
| PW TRACKING NUMBER | |
| PW WAGE LEVEL | III |
| 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 | |
| PREPARER FIRST NAME | |
| PREPARER MIDDLE INITIAL | |
| PREPARER BUSINESS NAME | |
| PREPARER EMAIL | |
| BEGIN DATE CONVERTED | 2025-07-01 |
