National Registry of EMTs
National Registry of EMTs
The mission of the National Registry of EMTs is to serve as the National EMS Certification organization by providing a valid, uniform process to assess the knowledge and skills required for competent practice by EMS professionals throughout their careers and by maintaining a registry of certification status.

2 Million
EMS Professionals

Have Been
Nationally Certified

Cognitive Exams

in 2016

Phone Calls

In 2016

50+ Million


The NREMT Values


Continually advocate for quality patient care.


Exhibit leadership and professionalism.


Function with integrity, honesty and objectivity.


Make decisions based on scientific evidence.


Provide excellent customer service and operate in a staff friendly environment.


Operate in accessible, open and collaborative manner.


Be fiscally responsible.


Be innovative and flexible in its efforts to support the EMS profession.


Act with impartiality through standardized, bias-free evaluation processes.

Professional Accreditation

The NREMT is accredited by the National Commission for Certifying Agencies (NCCA), the accreditation body of the Institute for Credentialing Excellence. The NREMT is also affiliated with the Commission on the Accreditation of Allied Health Educational Programs (CAAHEP).


  • Protects the Public
  • Assures consumers that professionals have met standards of practice
  • Advances the profession
  • Establishes standards of professional knowledge, skills, and practice

How States Use the NREMT

National Certification and EMS Licensure

National EMS Certification is an important component of public protection. The National Registry of Emergency Medical Technicians® (NREMT) provides National EMS Certification, which is a validated and legally defensible attestation of competency. When an individual obtains a National EMS Certification, the general public, employers, and state licensing authorities know that the individual has demonstrated competency.

The NREMT is recognized in every state in the United States, and forty-six states use the NREMT certification as a basis for licensure. States that do not use the NREMT must develop their own standards, which leads to inconsistency. In addition, these states must develop and defend their own examination/certification proves, which are generally not recognized by other states. Learn more about the differences between certification and licensure in this article.


On September 9, 1966, President Lyndon Johnson signed the National Traffic and Motor Vehicle Safety Act into law.

It has been nearly five decades since President Lyndon Johnson's Committee on Highway Traffic Safety recommended the creation of a national certification agency to establish uniform standards for training and examination of personnel active in the delivery of emergency ambulance service. The result of this recommendation was the inception of the National Registry of Emergency Medical Technicians (NREMT) in 1970. Prior to the 1970’s, a national certification standard for emergency medical care did not exist.

Since then, The NREMT has certified over one million EMS providers. Today, over 330,000 individuals are Nationally Certified at the Emergency Medical Responder (EMR), Emergency Medical Technician (EMT), Advanced-EMT (AEMT), or Paramedic level. Entry requirements for national EMS certification include completing a state-approved EMS education course, and passing the NREMT cognitive and psychomotor examinations.

Exam Development

The NREMT currently certifies four levels of Emergency Medical professionals: EMR, EMT, AEMT, and Paramedic. National experts in EMS including state officials, educators, employers, and EMS physicians write exam questions (items).

A single test item takes about one year to develop and pilot test, and costs approximately $1,600 to produce. Each of the item banks for the five levels of certification has thousands of questions that are calibrated to entry level competency, and lead to certification that is legally defensible and psychometrically sound. The overall chance of a candidate passing a NREMT cognitive exam by guessing on all items is statistically calculated to be 1 in 150,000,000. Learn more about the Cognitive Exam process.

How Entry Level Competency is Determined

Consistent standards set by the EMS community means patients can expect the same level of competency from EMS providers, regardless of whether they are volunteers or career-based, or located in urban or rural settings.

Certification through the NREMT indicates that a standard level of competency has been met. Certification means an individual has demonstrated entry level competency, but does not authorize a person to work. Emergency medical professionals are required to obtain a state license to work.

The NREMT defines entry level competency through committees of providers, regulators and medical directors. Examinations are directly tied to practice through data obtained from the NREMT Practice Analysis.

Assessing psychomotor competency (practical exam) takes place through an interdisciplinary team-oriented process involving EMS educators, State EMS Offices, thousands of skill station examiners across the country, examination site coordinators, hundreds of NREMT representatives, thousands of EMS system medical directors and others involved in the delivery of EMS.

Board of Directors

The NREMT Board of Directors is comprised of some of the nation’s most prominent experts in the medical field...

Maps & Data

An interactive repository of NREMT data and maps...

Annual Reports

The NREMT is a non-profit agency committed to public protection and the EMS profession. View our annual reports...