| CASE NUMBER | I-200-24291-413767 |
| CASE STATUS | Certified |
| RECEIVED DATE | 10/17/2024 |
| DECISION DATE | 10/24/2024 |
| ORIGINAL CERT DATE | |
| VISA CLASS | H-1B |
| JOB TITLE | Emergency Medicine Physician |
| SOC CODE | 29-1214.00 |
| SOC TITLE | Emergency Medicine Physicians |
| FULL TIME POSITION | N |
| BEGIN DATE | 12/1/2024 |
| END DATE | 4/14/2027 |
| 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 | USACS Medical Group Ltd. |
| TRADE NAME DBA | |
| EMPLOYER ADDRESS1 | 4535 Dressler Rd NW |
| EMPLOYER ADDRESS2 | |
| EMPLOYER CITY | Canton |
| EMPLOYER STATE | OH |
| EMPLOYER POSTAL CODE | 44718 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PROVINCE | |
| EMPLOYER PHONE | 13309944355 |
| EMPLOYER PHONE EXT | |
| NAICS CODE | 62111 |
| EMPLOYER POC LAST NAME | Fry |
| EMPLOYER POC FIRST NAME | Hope |
| EMPLOYER POC MIDDLE NAME | |
| EMPLOYER POC JOB TITLE | Immigration Manager |
| EMPLOYER POC ADDRESS1 | 4535 Dressler Rd NW |
| EMPLOYER POC ADDRESS2 | |
| EMPLOYER POC CITY | Canton |
| EMPLOYER POC STATE | OH |
| EMPLOYER POC POSTAL CODE | 44718 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PROVINCE | |
| EMPLOYER POC PHONE | 13309944213 |
| EMPLOYER POC PHONE EXT | |
| EMPLOYER POC EMAIL | fryh@usacs.com |
| AGENT REPRESENTING EMPLOYER | Yes |
| AGENT ATTORNEY LAST NAME | Jolic |
| AGENT ATTORNEY FIRST NAME | Michael |
| AGENT ATTORNEY MIDDLE NAME | M |
| AGENT ATTORNEY ADDRESS1 | 16959 Bernardo Center Drive |
| AGENT ATTORNEY ADDRESS2 | Suite 104 |
| AGENT ATTORNEY CITY | San Diego |
| AGENT ATTORNEY STATE | CA |
| AGENT ATTORNEY POSTAL CODE | 92128 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PROVINCE | |
| AGENT ATTORNEY PHONE | 18582586588 |
| AGENT ATTORNEY PHONE EXT | 107 |
| AGENT ATTORNEY EMAIL ADDRESS | michael@mjbimmigration.com |
| LAWFIRM NAME BUSINESS NAME | Martin Jolic and Associates, Inc. |
| STATE OF HIGHEST COURT | OH |
| NAME OF HIGHEST STATE COURT | Supreme Court |
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | Yes |
| SECONDARY ENTITY BUSINESS NAME | Bon Secours Southside Medical Center |
| WORKSITE ADDRESS1 | 200 Medical Park Blvd |
| WORKSITE ADDRESS2 | |
| WORKSITE CITY | Petersburg |
| WORKSITE COUNTY | PETERSBURG CITY |
| WORKSITE STATE | VA |
| WORKSITE POSTAL CODE | 23805 |
| WAGE RATE OF PAY FROM | $190.00 |
| WAGE RATE OF PAY FROM CLEANED | |
| WAGE RATE OF PAY TO | |
| WAGE UNIT OF PAY | Hour |
| PREVAILING WAGE | $115.00 |
| PW UNIT OF PAY | Hour |
| PW TRACKING NUMBER | |
| PW WAGE LEVEL | N/A |
| PW OES YEAR | 7/1/2024 - 6/30/2025 |
| 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 | 2024-12-01 |
