| LCA CASE NUMBER | I-200-21132-309298 |
| STATUS | Certified - Withdrawn |
| LCA CASE SUBMIT | 2021-05-12 |
| DECISION DATE | 2021-06-24 |
| ORIGINAL CERT DATE | 2021-05-19 |
| VISA CLASS | H-1B |
| LCA CASE JOB TITLE | Pediatrician |
| SOC CODE | 29-1065.00 |
| SOC TITLE | Pediatricians, General |
| FULL TIME POSITION | True |
| LCA CASE EMPLOYMENT START DATE | 2021-07-30 |
| END DATE | 2024-07-29 |
| TOTAL WORKER POSITIONS | 1 |
| NEW EMPLOYMENT | 1 |
| CONTINUED EMPLOYMENT | 0 |
| CHANGE PREVIOUS EMPLOYMENT | 0 |
| NEW CONCURRENT EMPLOYMENT | 0 |
| CHANGE EMPLOYER | 0 |
| AMENDED PETITION | 0 |
| LCA CASE EMPLOYER NAME | After Hours Pediatrics of Tennessee, P.C. |
| EMPLOYER ADDRESS1 | 265 Brookview Centre Way |
| EMPLOYER ADDRESS2 | Ste. 400 |
| EMPLOYER CITY | Knoxville |
| EMPLOYER STATE | TN |
| EMPLOYER POSTAL CODE | 37919 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PHONE | 18657696680 |
| NAICS CODE | 621111 |
| EMPLOYER POC LAST NAME | Dabbs |
| EMPLOYER POC FIRST NAME | Randal |
| EMPLOYER POC JOB TITLE | Authorized Signatory |
| EMPLOYER POC ADDRESS 1 | 265 Brookview Centre Way |
| EMPLOYER POC ADDRESS 2 | Ste. 400 |
| EMPLOYER POC CITY | Knoxville |
| EMPLOYER POC STATE | TN |
| EMPLOYER POC POSTAL CODE | 37919 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PHONE | 18657696680 |
| EMPLOYER POC EMAIL | tiffany_goins@teamhealth.com |
| AGENT REPRESENTING EMPLOYER | True |
| AGENT ATTORNEY LAST NAME | Bus |
| AGENT ATTORNEY FIRST NAME | Rachel |
| AGENT ATTORNEY MIDDLE NAME | I |
| AGENT ATTORNEY ADDRESS1 | 3080 N. Litchfield Road |
| AGENT ATTORNEY CITY | Goodyear |
| AGENT ATTORNEY STATE | AZ |
| AGENT ATTORNEY POSTAL CODE | 85395 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PHONE | 16235365750 |
| AGENT ATTORNEY EMAIL ADDRESS | rbus@breljelaw.com |
|
| LAWFIRM NAME BUSINESS NAME | Law Offices of Brelje and Associates, PC |
| STATE OF HIGHEST COURT | TX |
| NAME OF HIGHEST STATE COURT | Supreme Court of Texas |
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | True |
| SECONDARY ENTITY BUSINESS NAME | Children’s Hospital Urgent Care- Westland |
| WORKSITE ADDRESS1 | 1025 Children’s Way |
| LCA CASE WORKLOC1 CITY | Knoxville |
| WORKSITE COUNTY | KNOX |
| LCA CASE WORKLOC1 STATE | TN |
| WORKSITE POSTAL CODE | 37922 |
| LCA CASE WAGE RATE FROM | 120 |
| LCA CASE WAGE RATE UNIT | Hour |
| PREVAILING WAGE | 61.87 |
| PW UNIT OF PAY | Hour |
| PW WAGE LEVEL | I |
| PW OES YEAR | 7/1/2020 - 6/30/2021 |
| TOTAL WORKSITE LOCATIONS | 4 |
| AGREE TO LC STATEMENT | True |
| H1B DEPENDENT | False |
| WILLFUL VIOLATOR | False |
| PUBLIC DISCLOSURE | Disclose Business |
| PREPARER LAST NAME | Hoxie |
| PREPARER FIRST NAME | Drusilla |
| PREPARER BUSINESS NAME | Law Offices of Brelje and Associates, PC |
| PREPARER EMAIL | dhoxie@breljelaw.com |
