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 hours of continuing education that meets all requirements of the 2016 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 cognitive (knowledge) examination and psychomotor (skills) examination. 
    • Passed portions of the cognitive and psychomotor exam remain valid for 24 months provided all other eligibility requirements are met. 
  • Copy of a lapsed state Paramedic license/certification if never nationally certified as an Paramedic.
  • Have a current CPR-BLS for "Healthcare Provider" or equivalent credential. 

National Component - 30 Hours

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

Airway/Respiration/Ventilation - 3.5 Hours

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

Trauma - 3 Hours

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

Medical - 8.5 Hours

  • 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 - 6.5 Hours

  • 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 - 8.5 Hours

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


Local or State Component - 15 Hours

If specific local and/or state are not specified, these required hours 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 Hours

The individual hours 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 cognitive 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 (cognitive and psychomotor exams). 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