| LCA CASE NUMBER | I-200-21040-065566 |
| STATUS | Certified |
| LCA CASE SUBMIT | 2021-02-09 |
| DECISION DATE | 2021-02-17 |
| VISA CLASS | H-1B |
| LCA CASE JOB TITLE | Physician |
| SOC CODE | 29-1065.00 |
| SOC TITLE | Pediatricians, General |
| FULL TIME POSITION | True |
| LCA CASE EMPLOYMENT START DATE | 2021-08-01 |
| END DATE | 2024-07-29 |
| TOTAL WORKER POSITIONS | 1 |
| NEW EMPLOYMENT | 0 |
| CONTINUED EMPLOYMENT | 0 |
| CHANGE PREVIOUS EMPLOYMENT | 0 |
| NEW CONCURRENT EMPLOYMENT | 1 |
| CHANGE EMPLOYER | 0 |
| AMENDED PETITION | 0 |
| LCA CASE EMPLOYER NAME | Nebraska Pediatric Practice, Inc. |
| TRADE NAME DBA | Children's Specialty Physicians |
| EMPLOYER ADDRESS1 | 8200 Dodge Street |
| EMPLOYER CITY | Omaha |
| EMPLOYER STATE | NE |
| EMPLOYER POSTAL CODE | 68114 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PHONE | 14029556971 |
| NAICS CODE | 62111 |
| EMPLOYER POC LAST NAME | Simonsen |
| EMPLOYER POC FIRST NAME | Kari |
| EMPLOYER POC MIDDLE NAME | A |
| EMPLOYER POC JOB TITLE | Pediatrician-in-chief |
| EMPLOYER POC ADDRESS 1 | 8200 Dodge Street |
| EMPLOYER POC CITY | Omaha |
| EMPLOYER POC STATE | NE |
| EMPLOYER POC POSTAL CODE | 68114 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PHONE | 14029556971 |
| EMPLOYER POC EMAIL | smontgomery@childrensomaha.org |
| AGENT REPRESENTING EMPLOYER | True |
| AGENT ATTORNEY LAST NAME | Rock |
| AGENT ATTORNEY FIRST NAME | Daniel |
| AGENT ATTORNEY ADDRESS1 | 9290 W Dodge Rd, Suite 303 |
| AGENT ATTORNEY CITY | Omaha |
| AGENT ATTORNEY STATE | NE |
| AGENT ATTORNEY POSTAL CODE | 68114 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PHONE | 14023900390 |
| AGENT ATTORNEY EMAIL ADDRESS | drock@ellickjones.com |
| LAWFIRM NAME BUSINESS NAME | Ellick Jones Law Office |
| STATE OF HIGHEST COURT | NE |
| NAME OF HIGHEST STATE COURT | NEBRASKA |
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | False |
| WORKSITE ADDRESS1 | 8200 Dodge Street |
| LCA CASE WORKLOC1 CITY | Omaha |
| WORKSITE COUNTY | DOUGLAS |
| LCA CASE WORKLOC1 STATE | NE |
| WORKSITE POSTAL CODE | 68114 |
| LCA CASE WAGE RATE FROM | 115000 |
| LCA CASE WAGE RATE UNIT | Year |
| PREVAILING WAGE | 100984 |
| PW UNIT OF PAY | Year |
| PW WAGE LEVEL | II |
| PW OES YEAR | 7/1/2020 - 6/30/2021 |
| TOTAL WORKSITE LOCATIONS | 1 |
| AGREE TO LC STATEMENT | True |
| H1B DEPENDENT | False |
| WILLFUL VIOLATOR | False |
| PUBLIC DISCLOSURE | Disclose Business |
| PREPARER LAST NAME | Rock |
| PREPARER FIRST NAME | Daniel |
| PREPARER BUSINESS NAME | Ellick Jones Law Office |
| PREPARER EMAIL | drock@ellickjones.com |
