| LCA CASE NUMBER | I-200-21102-217255 |
| STATUS | Certified |
| LCA CASE SUBMIT | 2021-04-12 |
| DECISION DATE | 2021-04-19 |
| VISA CLASS | H-1B |
| LCA CASE JOB TITLE | Internal Medicine Physician |
| SOC CODE | 29-1069.03 |
| SOC TITLE | Hospitalists |
| FULL TIME POSITION | True |
| LCA CASE EMPLOYMENT START DATE | 2021-07-01 |
| END DATE | 2024-06-30 |
| TOTAL WORKER POSITIONS | 1 |
| NEW EMPLOYMENT | 0 |
| CONTINUED EMPLOYMENT | 1 |
| CHANGE PREVIOUS EMPLOYMENT | 0 |
| NEW CONCURRENT EMPLOYMENT | 0 |
| CHANGE EMPLOYER | 0 |
| AMENDED PETITION | 0 |
| LCA CASE EMPLOYER NAME | FHS Provider Services, Inc. |
| EMPLOYER ADDRESS1 | 178 Hwy 24 E |
| EMPLOYER CITY | Centreville |
| EMPLOYER STATE | MS |
| EMPLOYER POSTAL CODE | 36931 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PHONE | 16018900500 |
| NAICS CODE | 62111 |
| EMPLOYER POC LAST NAME | JACKSON |
| EMPLOYER POC FIRST NAME | ANGELA |
| EMPLOYER POC JOB TITLE | ADMINISTRATOR |
| EMPLOYER POC ADDRESS 1 | 451 BANK STREET |
| EMPLOYER POC CITY | WOODVILLE |
| EMPLOYER POC STATE | MS |
| EMPLOYER POC POSTAL CODE | 39669 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PHONE | 16018883421 |
| EMPLOYER POC EMAIL | AJACKSON@FHSMS.ORG |
| AGENT REPRESENTING EMPLOYER | True |
| AGENT ATTORNEY LAST NAME | Fanning |
| AGENT ATTORNEY FIRST NAME | Scott |
| AGENT ATTORNEY MIDDLE NAME | Christopher |
| AGENT ATTORNEY ADDRESS1 | 10 South Wacker Drive |
| AGENT ATTORNEY ADDRESS2 | Suite 3450 |
| AGENT ATTORNEY CITY | Chicago |
| AGENT ATTORNEY STATE | IL |
| AGENT ATTORNEY POSTAL CODE | 60606 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PHONE | 13125807800 |
| AGENT ATTORNEY EMAIL ADDRESS | sfanning@fisherphillips.com |
| LAWFIRM NAME BUSINESS NAME | Fisher & Phillips LLP |
| STATE OF HIGHEST COURT | IL |
|
| NAME OF HIGHEST STATE COURT | IL |
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | False |
| WORKSITE ADDRESS1 | 451 BANK STREET |
| LCA CASE WORKLOC1 CITY | WOODVILLE |
| WORKSITE COUNTY | WILKINSON |
| LCA CASE WORKLOC1 STATE | MS |
| WORKSITE POSTAL CODE | 39669 |
| LCA CASE WAGE RATE FROM | 200000 |
| LCA CASE WAGE RATE UNIT | Year |
| PREVAILING WAGE | 176301 |
| 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 Employment |
