| LCA CASE NUMBER | I-200-21250-569121 |
| STATUS | Certified |
| LCA CASE SUBMIT | 2021-09-07 |
| DECISION DATE | 2021-09-14 |
| VISA CLASS | H-1B |
| LCA CASE JOB TITLE | Physician |
| SOC CODE | 29-1069.00 |
| SOC TITLE | Physicians and Surgeons, All Other |
| FULL TIME POSITION | True |
| LCA CASE EMPLOYMENT START DATE | 2021-09-20 |
| END DATE | 2024-09-19 |
| 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 | Mountain States Physician Group, Inc. |
| TRADE NAME DBA | Ballad Health Medical Associates |
| EMPLOYER ADDRESS1 | 1905 American Way |
| EMPLOYER CITY | Kingsport |
| EMPLOYER STATE | TN |
| EMPLOYER POSTAL CODE | 37660 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PHONE | 14232308295 |
| NAICS CODE | 62111 |
| EMPLOYER POC LAST NAME | Lark |
| EMPLOYER POC FIRST NAME | Sherry |
| EMPLOYER POC MIDDLE NAME | D |
| EMPLOYER POC JOB TITLE | HR Director |
| EMPLOYER POC ADDRESS1 | 1905 American Way |
| EMPLOYER POC CITY | Kingsport |
| EMPLOYER POC STATE | TN |
| EMPLOYER POC POSTAL CODE | 37660 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PHONE | 14232308295 |
| EMPLOYER POC EMAIL | Sherry.Lark@balladhealth.org |
| AGENT REPRESENTING EMPLOYER | True |
| AGENT ATTORNEY LAST NAME | Eastridge |
| AGENT ATTORNEY FIRST NAME | Michael |
| AGENT ATTORNEY MIDDLE NAME | Andrew |
| AGENT ATTORNEY ADDRESS1 | 208 Sunset Drive |
| AGENT ATTORNEY ADDRESS2 | Suite 407 |
| AGENT ATTORNEY CITY | Johnson City |
| AGENT ATTORNEY STATE | TN |
| AGENT ATTORNEY POSTAL CODE | 37604 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PROVINCE | Tennessee |
| AGENT ATTORNEY PHONE | 12125184048 |
| AGENT ATTORNEY PHONE EXT | 101 |
| AGENT ATTORNEY EMAIL ADDRESS | meastridge@globaljusticeadvocates.com |
| LAWFIRM NAME BUSINESS NAME | Global Justice Advocates, PLLC |
| STATE OF HIGHEST COURT | TN |
| NAME OF HIGHEST STATE COURT | Supreme Court |
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | False |
| WORKSITE ADDRESS1 | 400 N. State of Franklin Rd. |
| LCA CASE WORKLOC1 CITY | Johnson City |
| WORKSITE COUNTY | WASHINGTON |
| LCA CASE WORKLOC1 STATE | TN |
| WORKSITE POSTAL CODE | 37604 |
| LCA CASE WAGE RATE FROM | 210000 |
| LCA CASE WAGE RATE UNIT | Year |
| PREVAILING WAGE | 208000 |
| PW UNIT OF PAY | Year |
| PW OES YEAR | 7/1/2021 - 6/30/2022 |
| TOTAL WORKSITE LOCATIONS | 1 |
| AGREE TO LC STATEMENT | True |
| H-1B DEPENDENT | False |
| WILLFUL VIOLATOR | False |
| PUBLIC DISCLOSURE | Disclose Business |
