| LCA CASE NUMBER | I-200-21273-616573 |
| STATUS | Certified |
| LCA CASE SUBMIT | 2021-09-30 |
| DECISION DATE | 2021-10-07 |
| VISA CLASS | H-1B |
| LCA CASE JOB TITLE | UI Designer |
| SOC CODE | 15-1132.00 |
| SOC TITLE | Software Developers, Applications |
| FULL TIME POSITION | True |
| LCA CASE EMPLOYMENT START DATE | 2021-10-01 |
| END DATE | 2024-09-30 |
| 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 | ProviderTrust Inc. |
| EMPLOYER ADDRESS1 | 406 11th Ave N |
| EMPLOYER ADDRESS2 | Suite 250 |
| EMPLOYER CITY | Nashville |
| EMPLOYER STATE | TN |
| EMPLOYER POSTAL CODE | 37203 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PHONE | 16159714993 |
| NAICS CODE | 541511 |
| EMPLOYER POC LAST NAME | Rosen |
| EMPLOYER POC FIRST NAME | Albert |
| EMPLOYER POC JOB TITLE | Co-Founder |
| EMPLOYER POC ADDRESS1 | 406 11th Avenue N |
| EMPLOYER POC ADDRESS2 | Suite 250 |
| EMPLOYER POC CITY | Nashville |
| EMPLOYER POC STATE | TN |
| EMPLOYER POC POSTAL CODE | 37203 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PHONE | 16159714993 |
| EMPLOYER POC EMAIL | mrosen@providertrust.com |
| AGENT REPRESENTING EMPLOYER | True |
| AGENT ATTORNEY LAST NAME | Cohen |
| AGENT ATTORNEY FIRST NAME | Adam |
| AGENT ATTORNEY MIDDLE NAME | Scott |
| AGENT ATTORNEY ADDRESS1 | 1028 Oakhaven Rd |
| AGENT ATTORNEY CITY | Memphis |
| AGENT ATTORNEY STATE | TN |
| AGENT ATTORNEY POSTAL CODE | 38119 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PHONE | 19016826455 |
| AGENT ATTORNEY EMAIL ADDRESS | acohen@visalaw.com |
| LAWFIRM NAME BUSINESS NAME | Siskind Susser PC |
| STATE OF HIGHEST COURT | FL |
| NAME OF HIGHEST STATE COURT | Supreme Court |
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | False |
| WORKSITE ADDRESS1 | 406 11th Avenue N |
| WORKSITE ADDRESS2 | Suite 250 |
| LCA CASE WORKLOC1 CITY | Nashville |
| WORKSITE COUNTY | DAVIDSON |
| LCA CASE WORKLOC1 STATE | TN |
| WORKSITE POSTAL CODE | 37203 |
| LCA CASE WAGE RATE FROM | 85000 |
| LCA CASE WAGE RATE UNIT | Year |
| PREVAILING WAGE | 80330 |
| PW UNIT OF PAY | Year |
| PW WAGE LEVEL | II |
| PW OES YEAR | 7/1/2021 - 6/30/2022 |
| TOTAL WORKSITE LOCATIONS | 1 |
| AGREE TO LC STATEMENT | True |
| H1B DEPENDENT | False |
| WILLFUL VIOLATOR | False |
| PUBLIC DISCLOSURE | Disclose Business |
| PREPARER LAST NAME | Schaffler |
| PREPARER FIRST NAME | Macrae |
| PREPARER BUSINESS NAME | Siskind Susser PC |
| PREPARER EMAIL | mschaffler@visalaw.com |
