If you have a lapsed National Registry Paramedic certification or lapsed state Paramedic license, including an equivalent state-recognized Paramedic certification, and want to gain National Registry Paramedic certification, you must meet the following requirements.

Requirements for Certification

  • 60 credits of continuing education that meets all requirements of the National Continued Competency Program within the past two years.
  • The National Registry accepts State EMS Office approved and CAPCE accredited education, education from EMS education programs, and U.S. accredited academic credit or college course. All education must be directly related to EMS patient care.
  • Successful completion of the National Registry Paramedic Certification Examination.
  • Copy of a lapsed state Paramedic license/certification if never nationally certified as an Paramedic.
  • Verification of skills competency prior to the first expiration date.
    1. Skills verification must be completed by one of the following mechanisms between the date of issuance of national EMS certification and the first expiration date.
    2. If the candidate does not successfully demonstrate skills verification within the allocated timeframe, the candidate will not be allowed to recertify, and the certification will lapse.
    3. Approved skills competency verification must be completed by one of the following methods:
      1. If the candidate affiliates with a National Registry Agency and has their skills competency verified (third-party) by their Agency’s medical director or training officer, this satisfies the requirement for re-entry. 
      2. A State EMS Office or State-Approved or CAAHEP Accredited Education Program.
      3. Provide verification of their current, full, and unrestricted state license.
        • With a current, full, and unrestricted state license to provide care, the candidate demonstrates minimum skills competency, as required by a state licensing body.

National Component - 30 Credits

The National Component requires Paramedics to complete 30 credits of approved continuing education. 

Airway/Respiration/Ventilation - 6 Credits

  • ​​​​​​Ventilation
  • Capnography
  • Oxygenation

Trauma - 5 Credits

  • Trauma Triage
  • Central Nervous System (CNS) Injury
  • Hemorrhage Control
  • Fluid Resuscitation

Medical - 8 Credits

  • Special Healthcare Needs
  • OB Emergencies
  • Infectious Diseases
  • Medication Delivery
  • Pain Management
  • Psychiatric and Behavioral Emergencies
  • Toxicological Emergencies - Opioids
  • Neurological Emergencies - Seizures
  • Endocrine Emergencies - Diabetes
  • Immunological Emergencies

Operations - 4 Credits

  • At-Risk Populations
  • Ambulance Safety
  • Field Triage—Disasters/MCIs
  • EMS Provider Hygiene, Safety, and Vaccinations
  • EMS Culture of Safety
  • Pediatric Transport
  • Crew Resource Management
  • EMS Research
  • Evidence Based Guidelines

Cardiovascular - 7 Credits

  • Post-Resuscitation Care
  • Ventricular Assist Devices
  • Stroke
  • Cardiac Arrest
  • Pediatric Cardiac Arrest
  • Congestive Heart Failure
  • Acute Coronary Syndrome


Local or State Component - 15 Credits

If specific local and/or state are not specified, these required credits are considered flexible content. You may use any state or Commission on Accreditation for Pre-Hospital Continuing Education (CAPCE) approved EMS–related education to fulfill these requirements. 

Individual Component - 15 Credits

The individual credits are considered flexible content. You may use any state or Commission on Accreditation for Pre-Hospital Continuing Education (CAPCE) approved EMS–related education to fulfill these requirements. 

Completion of a DOT Paramedic (NRP) Training Program must be completed after January 1, 1977.

All candidates for National Registry’s National EMS Certification at the Paramedic level whose Paramedic program began on or after January 1, 2013 must have successfully completed Paramedic education from an accredited program sponsored by the Commission on Accreditation of Allied Health Education Programs (CAAHEP) or one who held a valid Letter of Review (LOR)  issued by the Committee on Accreditation of Educational Programs for the Emergency Medical Services Professions (CoAEMSP).

Application Process

Follow these easy steps to apply for a National Registry exam:
  1. Create your account/log in to your profile.
  2. Create an application - Select the Paramedic level. Verify your personal information and make any necessary changes. Then, follow the prompts through the application process.
  3. Pay the application fee. The application fee is non-transferable and non-refundable. This fee is charged for each attempt of the certification examination.
  4. Email your lapsed state Paramedic license/certification (if applicable) and proof of education to support@nremt.org. Please include your application confirmation ID number.
  5. Monitor the progress of your application from your “Certification Application Status” in case additional actions are needed. Once the National Registry approves your application and your status is “Ready to Test,” you can view your ATT letter and contact Pearson Vue to schedule your exam.
Expiration Dates
Initial expiration dates are determined by the date the candidate successfully completes the entire national certification process. Paramedic candidates completing the national certification process between the January 1 and June 30 will receive an expiration date of March 31 two years in the future. Individuals successfully completing the national certification process between July 1 and December 31 will receive an expiration date of March 31 three years in the future.

Initial Certification

If you successfully complete the national
certification process between:

January 1 - June 30
July 1- December 31

Initial Cycle

Your initial certification date will be
March 31:

2 years in the future
3 years in the future