Individual provider Active NPI

Carlos Enrique Bonilla, DC

  • Chiropractor
  • Winston Salem, NC
National Provider Identifier
1972283174
Registry record updated Dec 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
5656 Issued in NC
Practice address
1515 Hanes Mall Blvd
Winston Salem, NC 27103-1358
Phone
(336) 773-7373
NPI assigned
Jul 21, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 5656 NC Primary

Addresses

Primary practice location

1515 Hanes Mall Blvd
Winston Salem, NC 27103-1358

Mailing address

35 Cambridge Oak Cir
Greensboro, NC 27410-9726

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230928002285 NC Practitioner - Chiropractic 1355795014 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gys Chiro IncGroup PAC ID 9133146541, 8 clinicians

Practice addresses (Care Compare)

1515 Hanes Mall Blvd
Winston Salem, NC 27103-1358
Phone (336) 773-7373

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5656NCMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Gys Chiro Inc Chiropractor CurrentSince Dec 22, 2025 Accepting new patients
Gys Chiro Inc Chiropractor PastSince Dec 22, 2025 Accepting new patients

Locations

3410 W Wendover Ave
Ste A
Greensboro, NC 27407
Phone (336) 274-3500

1515 Hanes Mall Blvd
Winston Salem, NC 27103
Phone (336) 773-7373

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1689897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766448000000",
    "number": "1972283174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35 CAMBRIDGE OAK CIR",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274109726"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1515 HANES MALL BLVD",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271031358",
            "telephone_number": "336-773-7373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONILLA",
        "first_name": "CARLOS",
        "middle_name": "ENRIQUE",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-07-21",
        "last_updated": "2025-12-23",
        "certification_date": "2025-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NC",
            "license": "5656",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.