| CASE NUMBER | I-200-24303-439126 |
| CASE STATUS | Certified |
| RECEIVED DATE | 10/29/2024 |
| DECISION DATE | 11/5/2024 |
| ORIGINAL CERT DATE | |
| VISA CLASS | H-1B |
| JOB TITLE | Hospitalist |
| SOC CODE | 29-1229.02 |
| SOC TITLE | Hospitalists |
| FULL TIME POSITION | N |
| BEGIN DATE | 2/17/2025 |
| END DATE | 2/16/2028 |
| 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 | Wentworth-Douglass Physician Corporation |
| TRADE NAME DBA | Wentworth Health Partners |
| EMPLOYER ADDRESS1 | Wentworth-Douglass Hospital, 789 Central Ave. |
| EMPLOYER ADDRESS2 | |
| EMPLOYER CITY | Dover |
| EMPLOYER STATE | NH |
| EMPLOYER POSTAL CODE | 3820 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PROVINCE | |
| EMPLOYER PHONE | 16036096925 |
| EMPLOYER PHONE EXT | |
| NAICS CODE | 622110 |
| EMPLOYER POC LAST NAME | Ganier |
| EMPLOYER POC FIRST NAME | Lindsay |
| EMPLOYER POC MIDDLE NAME | |
| EMPLOYER POC JOB TITLE | President & COO of MBG Medical Group |
| EMPLOYER POC ADDRESS1 | Wentworth-Douglass Hospital, 789 Central Ave. |
| EMPLOYER POC ADDRESS2 | |
| EMPLOYER POC CITY | Dover |
| EMPLOYER POC STATE | NH |
| EMPLOYER POC POSTAL CODE | 3820 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PROVINCE | |
| EMPLOYER POC PHONE | 16036096925 |
| EMPLOYER POC PHONE EXT | |
| EMPLOYER POC EMAIL | imccain@mgb.org |
| AGENT REPRESENTING EMPLOYER | Yes |
| AGENT ATTORNEY LAST NAME | White |
| AGENT ATTORNEY FIRST NAME | Emily |
| AGENT ATTORNEY MIDDLE NAME | A. |
| AGENT ATTORNEY ADDRESS1 | Orr & Reno, P.O. Box 3550 |
| AGENT ATTORNEY ADDRESS2 | |
| AGENT ATTORNEY CITY | Concord |
| AGENT ATTORNEY STATE | NH |
| AGENT ATTORNEY POSTAL CODE | 03302-3550 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PROVINCE | |
| AGENT ATTORNEY PHONE | 16032239175 |
| AGENT ATTORNEY PHONE EXT | |
| AGENT ATTORNEY EMAIL ADDRESS | csalvato@orr-reno.com |
| LAWFIRM NAME BUSINESS NAME | Orr & Reno, P.A. |
| STATE OF HIGHEST COURT | NH |
| NAME OF HIGHEST STATE COURT | New Hampshire |
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | No |
| SECONDARY ENTITY BUSINESS NAME | |
| WORKSITE ADDRESS1 | Wentworth-Douglass Hospital, 789 Central Avenue |
| WORKSITE ADDRESS2 | |
| WORKSITE CITY | Dover |
| WORKSITE COUNTY | DOVER CITY |
| WORKSITE STATE | NH |
| WORKSITE POSTAL CODE | 3820 |
| WAGE RATE OF PAY FROM | $170.00 |
| WAGE RATE OF PAY FROM CLEANED | |
| WAGE RATE OF PAY TO | |
| WAGE UNIT OF PAY | Hour |
| PREVAILING WAGE | $36.77 |
| PW UNIT OF PAY | Hour |
| PW TRACKING NUMBER | |
| PW WAGE LEVEL | I |
| 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 | Salvato |
| PREPARER FIRST NAME | Cody |
| PREPARER MIDDLE INITIAL | S. |
| PREPARER BUSINESS NAME | Orr & Reno, P.A. |
| PREPARER EMAIL | csalvato@orr-reno.com |
| BEGIN DATE CONVERTED | 2025-02-17 |
