| LCA CASE NUMBER | I-200-21354-776724 |
| STATUS | Certified |
| LCA CASE SUBMIT | 2021-12-20 |
| DECISION DATE | 2021-12-28 |
| VISA CLASS | H-1B |
| LCA CASE JOB TITLE | HOSPITALIST |
| SOC CODE | 29-1069.00 |
| SOC TITLE | Physicians and Surgeons, All Other |
| FULL TIME POSITION | True |
| LCA CASE EMPLOYMENT START DATE | 2022-06-01 |
| END DATE | 2025-05-31 |
| 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 | Cumberland County Hospital System, Inc. |
| TRADE NAME DBA | Cape Fear Valley Medical Center |
| EMPLOYER ADDRESS1 | 1638 Owen Drive |
| EMPLOYER CITY | Fayetteville |
| EMPLOYER STATE | NC |
| EMPLOYER POSTAL CODE | 28304 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PHONE | 19106155152 |
| NAICS CODE | 622110 |
| EMPLOYER POC LAST NAME | Nagowski |
| EMPLOYER POC FIRST NAME | Michael |
| EMPLOYER POC JOB TITLE | Chief Executive Officer |
| EMPLOYER POC ADDRESS1 | 1638 Owen Drive |
| EMPLOYER POC CITY | Fayetteville |
| EMPLOYER POC STATE | NC |
| EMPLOYER POC POSTAL CODE | 28304 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PHONE | 19106155812 |
| EMPLOYER POC EMAIL | mnagowski@capefearvalley.com |
| AGENT REPRESENTING EMPLOYER | True |
| AGENT ATTORNEY LAST NAME | REYES GONZALEZ |
| AGENT ATTORNEY FIRST NAME | ADRIANA |
| AGENT ATTORNEY MIDDLE NAME | H |
| AGENT ATTORNEY ADDRESS1 | 2801 VIA FORTUNA |
| AGENT ATTORNEY ADDRESS2 | SUITE 650 |
| AGENT ATTORNEY CITY | AUSTIN |
| AGENT ATTORNEY STATE | TX |
| AGENT ATTORNEY POSTAL CODE | 78746 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PHONE | 15124826830 |
| AGENT ATTORNEY EMAIL ADDRESS | KAYLA.SPENCER@KLGATES.COM |
| LAWFIRM NAME BUSINESS NAME | K&L GATES LLP |
|
| STATE OF HIGHEST COURT | TX |
| NAME OF HIGHEST STATE COURT | SUPREME COURT OF TEXAS |
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | False |
| WORKSITE ADDRESS1 | 1638 OWEN DRIVE |
| LCA CASE WORKLOC1 CITY | FAYETTEVILLE |
| WORKSITE COUNTY | CUMBERLAND |
| LCA CASE WORKLOC1 STATE | NC |
| WORKSITE POSTAL CODE | 28304 |
| LCA CASE WAGE RATE FROM | 261000 |
| LCA CASE WAGE RATE TO | 282960 |
| LCA CASE WAGE RATE UNIT | Year |
| PREVAILING WAGE | 187346 |
| PW UNIT OF PAY | Year |
| PW WAGE LEVEL | III |
| 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 | SPENCER |
| PREPARER FIRST NAME | KAYLA |
| PREPARER BUSINESS NAME | K&L GATES LLP |
| PREPARER EMAIL | KAYLA.SPENCER@KLGATES.COM |
