{"entity":{"id":15971059,"state":"FL","state_id":"F97000003879","entity_name":"PHYCOR OF FT. WALTON BEACH, INC.","entity_type":"FORP","entity_type_normalized":"foreign_profit","status":"I","filing_date":"1997-07-24","filing_year":1997,"business_age_years":29,"principal_address1":"30 BURTON HILLS BOULEVARD, SUITE 400","principal_address2":"","principal_city":"NASHVILLE","principal_state":"TN","principal_zip":"37215","principal_country":"US","mail_address1":"30 BURTON HILLS BOULEVARD, SUITE 400","mail_address2":"","mail_city":"NASHVILLE","mail_state":"TN","mail_zip":"37215","mail_country":"US","location_name":null,"location_address1":null,"location_address2":null,"location_city":null,"location_state":null,"location_zip":null,"fei_ein":"621687092","jurisdiction":null,"county":null,"last_transaction_date":"10012004","report_year_1":"2003","report_date_1":"04282003","report_year_2":"2003","report_date_2":"04282003","report_year_3":"2002","report_date_3":"04222002","agent_name":"Service Company Corporation","agent_type":"C","agent_address":"1201 HAYS STREET","agent_city":"TALLAHASSEE","agent_state":"FL","agent_zip":"323012525","process_name":null,"process_address1":null,"process_address2":null,"process_city":null,"process_state":null,"process_zip":null,"source_file":"cordata9.txt","fetched_at":"2026-05-09 15:57:16","updated_at":"2026-05-09 15:57:16","last_accessed":null,"status_reason":null,"agent_name_raw":"CORPORATION SERVICE COMPANY"},"officers":[{"name":"Thompson S Dent","first_name":"Thompson","last_name":"Dent","title":"Director","title_roles":["Director"],"title_code":"director","is_registered_agent":false,"address":"411 HACKENSACK AVENUE 7TH FLOOR","city":"HACKENSACK","state":"NJ","zip":"07601","name_raw":"DENT                THOMPSON      S"},{"name":"Monte S Frankenfield","first_name":"Monte","last_name":"Frankenfield","title":"Vice President, Assistant, Secretary","title_roles":["Vice President","Assistant","Secretary"],"title_code":"vas","is_registered_agent":false,"address":"30 BURTON HILLS BOULEVARD, SUITE 400","city":"NASHVILLE","state":"TN","zip":"37215","name_raw":"FRANKENFIELD        MONTE         S"},{"name":"Joseph D Mark","first_name":"Joseph","last_name":"Mark","title":"President, Treasurer, Assistant, Secretary","title_roles":["President","Treasurer","Assistant","Secretary"],"title_code":"ptas","is_registered_agent":false,"address":"411 HACKENSACK AVENUE, 7TH FL.","city":"HACKENSACK","state":"NJ","zip":"07601","name_raw":"MARK                JOSEPH        D"},{"name":"Jan M Sundock","first_name":"Jan","last_name":"Sundock","title":"Vice President, General Partner, Chairman","title_roles":["Vice President","General Partner","Chairman"],"title_code":"vgc","is_registered_agent":false,"address":"30 BURTON HILLS BOULEVARD, SUITE 400","city":"NASHVILLE","state":"TN","zip":"37215","name_raw":"SUNDOCK             JAN           M"}],"filing_history":[],"status_history":[],"unknown":["status_history: we do not collect status-change histories from the source feeds, so this empty list means we hold none — NOT that this company's status has never changed. Observed changes we DID see are under `history`."],"verified_domains":[],"history":null,"web_contact":null,"provenance_url":"https://private.rootz.global/api/provenance/FL/F97000003879"}